Nokea
An example of a first-dose reaction that may occur includes:
- A. Orthostatic hypotension that does not occur with repeated doses
- B. Purple glove syndrome with phenytoin use
- C. Hemolytic anemia from ceftriaxone use
- D. Contact dermatitis from neomycin use
Correct Answer: C
Rationale: Hemolytic anemia from ceftriaxone can occur after the first dose as a Type II reaction, unlike orthostatic hypotension (A, adaptive) or others (B, D, later onset).
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A nurse is caring for a client who received IV Verapamil to treat supraventricular tachycardia (SVT). The client's pulse rate is now 98/min and his blood pressure is 74/44 mg hg. The nurse should anticipate a prescription for which of the following IV medications?
- A. Calcium gluconate
- B. Sodium bicarbonate
- C. Potassium chloride
- D. Magnesium sulfate
Correct Answer: A
Rationale: Calcium gluconate reverses verapamil-induced hypotension by counteracting calcium channel blockade.
Newborns are at risk for early vitamin K deficiency bleeding and the American Academy of Pediatrics recommends that all newborns receive:
- A. IM vitamin K (phytonadione) within 24 hours of birth
- B. Oral vitamin K supplementation in the first 3 weeks of life
- C. Formula containing vitamin K or breast milk
- D. Oral vitamin K in the first 24 hours after birth
Correct Answer: A
Rationale: IM vitamin K is standard to prevent vitamin K deficiency bleeding in newborns.
This drug is a respiratory stimulant:
- A. Doxapram
- B. Promethazine
- C. Dornase α
- D. Oxygen
Correct Answer: A
Rationale: Doxapram stimulates breathing by acting on the respiratory center in the brainstem.
A 49-year-old woman with a history of hypertension is treated with spironolactone. She has good blood pressure control and in the last 6 months has shown an improvement in her hirsutism. What is the most likely explanation for these findings?
- A. Androgen receptor inhibition of the hair follicle
- B. Drug toxicity
- C. Hypoaldosteronism
- D. Testosterone levels are elevated
Correct Answer: A
Rationale: Spironolactone's anti-androgenic effects inhibit androgen receptors, reducing hirsutism, alongside its aldosterone antagonism for hypertension.
A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment?
- A. Monitoring the leukocyte count for 2 days after the infusion
- B. Checking the frequency and consistency of bowel movements
- C. Checking serum liver enzyme levels before and after the infusion
- D. Carrying out a Hematest on gastric fluids after the infusion is completed
Correct Answer: B
Rationale: The principal manifestations of Crohn's disease are diarrhea and abdominal pain. Infliximab (Remicade) is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea. Options 1, 3, and 4 are unrelated to this medication.