Barbiturates are contraindicated in a dental patient with: II. emphysema III. Undiagnosed severe pain III. hypertension IV. Acute intermittent porphyria
- A. I, III & IV
- B. I & IV only
- C. II & III only
- D. II only
Correct Answer: A
Rationale: Barbiturates are central nervous system depressants that can exacerbate conditions such as emphysema, hypertension, and acute intermittent porphyria.
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A patient is in the emergency department with new-onset atrial fibrillation. Which order for digoxin would most likely have the fastest therapeutic effect?
- A. Digoxin 0.25 mg PO daily
- B. Digoxin 1 mg PO now; then 0.25 mg PO daily
- C. Digoxin 0.5 mg IV push daily
- D. Digoxin 1 mg IV push now; then 0.25 mg IV daily
Correct Answer: D
Rationale: When a patient requires immediate treatment for atrial fibrillation with digoxin, the fastest way to achieve a therapeutic effect is through intravenous administration. Option D, Digoxin 1 mg IV push now; then 0.25 mg IV daily, is the most appropriate order in this scenario. Intravenous administration allows for rapid absorption and onset of action, making it the preferred route for urgent situations like atrial fibrillation. By giving an initial loading dose intravenously, followed by a lower maintenance dose IV daily or orally, the patient can quickly achieve therapeutic digoxin levels to help stabilize the heart rhythm. Option D provides the most rapid and effective way to manage new-onset atrial fibrillation with digoxin.
The nurse is teaching a patient about taking aspirin. Which are important points to include? (Select all that apply.)
- A. Advise the patient to avoid alcohol while taking aspirin.
- B. Instruct the patient to take aspirin before meals on an empty stomach.
- C. Instruct the patient to inform the dentist of the aspirin dosage before having dental work.
- D. Instruct the patient to inform the surgeon of the aspirin dosage before having surgery.
Correct Answer: D
Rationale: Aspirin is an antiplatelet agent that can increase the risk of bleeding, especially when combined with alcohol or during invasive procedures like dental work or surgery. Patients should avoid alcohol to reduce the risk of gastrointestinal bleeding. Additionally, informing healthcare providers about aspirin use is crucial to prevent excessive bleeding during procedures. Taking aspirin on an empty stomach is not recommended, as it can increase the risk of gastric irritation. Therefore, the correct teaching points are to avoid alcohol, inform the dentist, and inform the surgeon about aspirin use.
What should you monitor when given a patient Clopidogrel?
- A. Signs of thrombotic thrombolytic purpura
- B. Bleeding during therapy
- C. CBC with differential and platelet count
- D. All the above
Correct Answer: D
Rationale: When monitoring a patient on Clopidogrel therapy, it is important to monitor for signs of thrombotic thrombolytic purpura (TTP), bleeding during therapy, and changes in blood counts. Clopidogrel is an antiplatelet medication that works by preventing platelets from sticking together and forming clots. Monitoring for signs of TTP is necessary as clopidogrel has been associated with an increased risk of TTP in some patients. Additionally, monitoring for bleeding is crucial as clopidogrel, like other antiplatelet medications, can increase the risk of bleeding complications. Monitoring a complete blood count (CBC) with differential and platelet count allows healthcare providers to assess the patient's blood cell levels and ensure that the medication is not causing any adverse effects on blood counts. Therefore, monitoring all of the above parameters is essential to ensure the safety and efficacy of clopidogrel therapy.
A contraindication for topical corticosteroid usage in a male patient with atopic dermatitis (eczema) is:
- A. Parasite infection.
- B. Viral infection.
- C. Bacterial infection.
- D. Spirochete infection.
Correct Answer: B
Rationale: Topical corticosteroids can exacerbate viral infections, such as herpes simplex, by suppressing the immune response. They are contraindicated in the presence of viral infections to prevent worsening of the condition. Bacterial, parasitic, and spirochete infections are not absolute contraindications, although caution is advised.
Which of the following diuretics inhibits sodium reabsorption in the kidneys while saving K+ and Hydrogen ions?
- A. Spironolactone
- B. Furosemide
- C. Hydrochlorothiazide
- D. Bumetanide
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic, which means it inhibits sodium reabsorption in the kidneys, while saving potassium and hydrogen ions. It accomplishes this by acting as an aldosterone antagonist, blocking the action of aldosterone. Aldosterone is a hormone that normally promotes sodium reabsorption in the kidneys and leads to potassium and hydrogen ion excretion. By inhibiting aldosterone, spironolactone promotes sodium excretion while conserving potassium and hydrogen ions.