Nokea
Drugs that should be avoided in the elderly include:
- A. Acetaminophen
- B. Amitriptyline
- C. Amoxicillin
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because amitriptyline, a tricyclic antidepressant, is avoided in the elderly (per Beers Criteria) due to anticholinergic effects causing confusion, constipation, and falls. Choice A is incorrect as acetaminophen is safe. Choice C is wrong because amoxicillin is appropriate with dose adjustment. Choice D is incorrect since only amitriptyline fits.
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Men may require higher doses of which drug class due to differences in body composition?
- A. Lipid-soluble drugs
- B. Water-soluble drugs
- C. Drugs that are highly protein bound
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because men's greater lean mass dilutes water-soluble drugs, often requiring higher doses for efficacy, unlike others. Choice A is incorrect as lipid-soluble drugs align with fat, lower in men. Choice C is wrong because protein binding isn't sex-specific here. Choice D is incorrect since only water-soluble drugs apply.
What is the initial action the nurse should take for a client who had a myocardial infarction (MI) and is experiencing restlessness, agitation, and an increased respiratory rate?
- A. Administer oxygen.
- B. Administer morphine sulfate.
- C. Notify the healthcare provider.
- D. Take the client's blood pressure.
Correct Answer: A
Rationale: Administering oxygen is the priority action for a client experiencing restlessness, agitation, and an increased respiratory rate after a myocardial infarction (MI). This intervention helps ensure adequate oxygenation, improve cardiac function, and reduce the workload on the heart. Oxygen therapy takes precedence over administering medications like morphine sulfate or notifying the healthcare provider as it addresses the immediate need for oxygenation. Checking the blood pressure is also important but not as urgent as ensuring proper oxygen supply.
After administering nitroglycerin to a client with coronary artery disease (CAD) who reports chest pain, what should be the nurse's next priority action?
- A. Obtain a 12-lead ECG
- B. Monitor the client's blood pressure
- C. Notify the healthcare provider
- D. Administer a second dose of nitroglycerin
Correct Answer: B
Rationale: The correct next priority action after administering nitroglycerin to a client with CAD experiencing chest pain is to monitor the client's blood pressure. Nitroglycerin can cause hypotension, so it is crucial to assess and monitor the client's blood pressure for any signs of decreased perfusion or adverse effects. Obtaining a 12-lead ECG may be important but is not the immediate priority. Notifying the healthcare provider and administering a second dose of nitroglycerin should only be considered after ensuring the client's blood pressure is stable.
Risk factors for drug abuse include:
- A. Family history of addiction
- B. Mental health disorders
- C. Peer pressure
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because family history (genetic predisposition), mental health issues (self-medication), and peer pressure (social influence) are all established risk factors, per SAMHSA. Choice A is incorrect alone as it's one factor. Choice B is wrong by itself because mental health is just part. Choice C is incorrect solo since pressure is only one element.
A client with a history of angina pectoris reports chest pain after climbing stairs. What should be the nurse's first action?
- A. Administer oxygen.
- B. Administer nitroglycerin.
- C. Sit the client down and rest.
- D. Check the client's blood pressure.
Correct Answer: C
Rationale: The correct action for a client experiencing anginal pain, like chest pain after climbing stairs, is to sit the client down and have them rest. Resting reduces myocardial oxygen demand, which can help relieve anginal pain. Administering oxygen or nitroglycerin may be appropriate interventions after the client has been seated and rested. Checking the client's blood pressure is important but not the immediate priority when a client is experiencing anginal pain. Therefore, the first action should be to sit the client down and allow them to rest.