Nokea
For a patient with asthma, what is the primary purpose of prescribing montelukast?
- A. Relieve acute bronchospasm
- B. Prevent asthma attacks
- C. Thin respiratory secretions
- D. Suppress cough
Correct Answer: B
Rationale: The primary purpose of prescribing montelukast for a patient with asthma is to prevent asthma attacks. Montelukast is a leukotriene receptor antagonist that helps to reduce inflammation in the airways, thereby preventing asthma symptoms and attacks. It is not used to relieve acute bronchospasm (Choice A), as it is not a fast-acting rescue medication like a bronchodilator. Montelukast also does not thin respiratory secretions (Choice C) or suppress cough (Choice D) as its main mechanism of action is to prevent and control asthma symptoms by inhibiting leukotrienes.
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What is the primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT)?
- A. No need for regular INR monitoring
- B. Lower risk of bleeding
- C. Fewer dietary restrictions
- D. Longer half-life
Correct Answer: A
Rationale: The primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of DVT is the absence of regular INR monitoring required with rivaroxaban. This is because rivaroxaban is a direct oral anticoagulant with more predictable pharmacokinetics, eliminating the need for monitoring. Regular INR monitoring is necessary with warfarin to ensure the drug is within the therapeutic range, which can be burdensome for patients and healthcare providers. The other choices are incorrect as they do not directly address the primary advantage of rivaroxaban over warfarin for this specific patient population.
A client is admitted with a diagnosis of acute pancreatitis. Which laboratory value should the nurse monitor closely?
- A. Serum amylase.
- B. Serum sodium.
- C. Serum calcium.
- D. Serum potassium.
Correct Answer: A
Rationale: The correct answer is A: Serum amylase. In acute pancreatitis, there is inflammation of the pancreas leading to elevated serum amylase levels. Amylase is an enzyme produced by the pancreas, and increased levels indicate pancreatic injury. Monitoring serum amylase helps in diagnosing and assessing the severity of pancreatitis.
Choice B: Serum sodium, and Choice D: Serum potassium may be affected in pancreatitis due to fluid shifts, but they are not specific markers for pancreatitis.
Choice C: Serum calcium may also be affected in pancreatitis, but monitoring serum calcium is not as crucial as monitoring serum amylase for diagnosing and managing acute pancreatitis.
A patient with glaucoma is prescribed timolol eye drops. What is the primary action of this medication?
- A. Reduce intraocular pressure
- B. Dilate the pupils
- C. Constrict the pupils
- D. Enhance tear production
Correct Answer: A
Rationale: The correct answer is A: Reduce intraocular pressure. Timolol is a beta-blocker that works by decreasing the production of aqueous humor in the eye, thereby reducing intraocular pressure. This action helps to prevent damage to the optic nerve in patients with glaucoma. Choices B and C are incorrect because timolol does not affect pupil size. Choice D is incorrect because timolol does not enhance tear production; in fact, it may have a drying effect on the eyes.
A patient with rheumatoid arthritis is taking prednisone. What is an important side effect for the nurse to monitor?
- A. Hyperglycemia
- B. Bradycardia
- C. Hypotension
- D. Hyperkalemia
Correct Answer: A
Rationale: The correct answer is A: Hyperglycemia. Prednisone is a corticosteroid that can cause an increase in blood glucose levels by promoting gluconeogenesis and decreasing insulin sensitivity. Monitoring for hyperglycemia is crucial as it can lead to serious complications such as diabetic ketoacidosis. Bradycardia (B) and hypotension (C) are not typical side effects of prednisone, as it tends to cause fluid retention and hypertension. Hyperkalemia (D) is also unlikely as prednisone can actually cause hypokalemia due to increased renal potassium excretion.
A patient with epilepsy is prescribed phenytoin. What is the primary side effect the nurse should monitor for?
- A. Hypotension
- B. Gingival hyperplasia
- C. Bradycardia
- D. Hyperkalemia
Correct Answer: B
Rationale: The correct answer is B: Gingival hyperplasia. Phenytoin is known to cause gingival overgrowth as a side effect. This is due to its effect on fibroblasts in the gums, leading to increased connective tissue production. Hypotension (A), bradycardia (C), and hyperkalemia (D) are not common side effects of phenytoin. Monitoring for gingival hyperplasia is crucial to prevent complications such as difficulty in eating, speaking, and maintaining oral hygiene.