Nokea
Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:
- A. Dwayne hasn't been taking his carbamazepine because it causes insomnia.
- B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
- C. Dwayne was not originally prescribed the correct amount of carbamazepine.
- D. Carbamazepine is probably not the right antiseizure medication for Dwayne.
Correct Answer: B
Rationale: Carbamazepine induces its own metabolism (auto-induction), reducing levels over time.
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Sadie was prescribed betaxolol ophthalmic drops by her ophthalmologist to treat her glaucoma. Oral beta blockers should be avoided in patients who use ophthalmic beta blockers because:
- A. There may be an antagonistic reaction between the two
- B. The additive effects may include bradycardia
- C. They may potentiate each other and cause respiratory depression
- D. The additive effects may cause metabolic acidosis
Correct Answer: B
Rationale: Ophthalmic betaxolol can add to oral beta blockers, risking bradycardia; respiratory or acidosis are less likely.
A nurse is assessing a pregnant client and learns that the client is addicted to cocaine. The nurse informs the client about the risks of cocaine addiction for her fetus. Which of the following would the nurse include?
- A. The child may be born with diabetes.
- B. The child may be born with hypertension.
- C. The child may be born with an addiction to drugs.
- D. The child may be born with CNS defects.
Correct Answer: C
Rationale: The nurse informs the client that children born to mothers using addictive drugs are often born with an addiction to the drug. Children born to mothers who are addicted to cocaine are not known to be born with diabetes, CNS defects, or hypertension.
Rho immune globulin (RhoGAM) is given to:
- A. Infants born to women who are Rh positive
- B. Sexual partners of Rh-positive women
- C. Rh-negative women after a birth, miscarriage, or abortion
- D. Rh-negative women at 36 weeks gestation
Correct Answer: C
Rationale: RhoGAM prevents Rh sensitization in Rh-negative women post-delivery; it's not for infants , partners , or late gestation alone.
A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?
- A. I will clean the site with an alcohol swab before I apply the patch.
- B. I will rotate the application sites weekly.
- C. I will apply the patch to an area of skin with no hair.
- D. I will place the new patch on the site of the old patch.
Correct Answer: A
Rationale: Cleaning the site with alcohol ensures proper adhesion and absorption, a key instruction for transdermal patches.
The antidote for paracetamol poisoning is:
- A. Acetylsalicylic acid
- B. Acetylcysteine
- C. Prostacyclin
- D. Omeprazole
Correct Answer: B
Rationale: Acetylcysteine replenishes glutathione, detoxifying paracetamol's toxic metabolite.