For the treatment of morphine addiction which of the following drug is substituted?
- A. Tramadol
- B. Methadone
- C. Fluoxetine
- D. Dextromethorphan
Correct Answer: B
Rationale: Methadone, a long-acting opioid agonist, is commonly substituted for morphine in addiction treatment to reduce withdrawal symptoms and cravings.
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A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. After reaching the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.
Factors that facilitate keeping patient information confidential in an electronic health record (EHR) system include:
- A. Designing software so that only those who need the information can gain access
- B. Requiring providers to log off at the end of the clinical day
- C. Keeping a file of the login and password information for each provider in a secure place
- D. Having patients sign informed consent documents to have their data on an EHR
Correct Answer: A
Rationale: Restricted access software enhances EHR confidentiality.
Zoster vaccine (Zostavax) is:
- A. A live varicella zoster vaccine from the same strain used to develop the varicella vaccine
- B. Effective in preventing varicella zoster in patients of all ages
- C. Recommended for patients age 40 to 80 who have had chickenpox
- D. Administered at the same time as other live vaccines, as long as they are given the same day
Correct Answer: A
Rationale: Zostavax is a live vaccine from the varicella strain, for adults 50+ (not all ages, B, or 40-80, C); timing with other vaccines has restrictions.
Following are the true receptors, except one
- A. Beta adrenergic receptors
- B. Na-K-ATP ase
- C. Phosphodiesterase
- D. Plasma proteins
Correct Answer: D
Rationale: Plasma proteins bind drugs but are not receptors.
A nurse is assessing a client who has taken Procainamide to treat dysrhythmias for the last 12 months. The nurse should assess the client for which of the following adverse effects of this medication? (Select one that does not apply.)
- A. Joint swelling
- B. Widened QRS complex
- C. Narrowed QT interval
- D. Easy bruising
Correct Answer: C
Rationale: Procainamide can widen QRS , cause bruising from lupus-like syndrome, and joint swelling .
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