Nokea
Identify a reason a narcotic agent may be prescribed.
- A. Relief of moderate acute pain.
- B. Relief of minor pain.
- C. Analgesia during sleep.
- D. Analgesia during anesthesia.
Correct Answer: A
Rationale: The correct answer is A: Relief of moderate acute pain. Narcotic agents are potent pain relievers typically prescribed for moderate to severe acute pain due to their strong analgesic properties. They work by binding to opioid receptors in the brain and spinal cord, blocking pain signals. Choice B is incorrect as narcotics are usually reserved for more intense pain. Choices C and D are incorrect because narcotics are not typically used for analgesia during sleep or anesthesia, as they can cause respiratory depression and other complications.
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The nurse is caring for a patient that has seizure disorder. The nurse notes that the patient has reddened gums that bleed when oral care is given. The nurse recognizes this finding as:
- A. A sign of poor self-care.
- B. A drug interaction with aspirin.
- C. An adverse effect of the phenytoin.
- D. A symptom of hepatotoxicity.
Correct Answer: C
Rationale: The correct answer is C: An adverse effect of phenytoin. Phenytoin is an antiepileptic drug known to cause gingival hyperplasia, leading to reddened and bleeding gums. This is a common side effect of phenytoin due to its effect on gingival tissues. Poor self-care (choice A) may contribute to gingival issues, but in this case, the patient's gums are affected by a medication side effect. There is no indication in the question of aspirin use (choice B) or hepatotoxicity (choice D) causing the gum issues. Therefore, the most likely explanation is the adverse effect of phenytoin.
The nurse is caring for a patient with Parkinson's Disease. While writing the care plan for the patient, what would be an appropriate diagnosis?
- A. Constipation related to dopaminergic effects.
- B. Risk for injuries related to CVS effects and PVD.
- C. Risk for injury related to CVS effects and incidence of orthostatic hypotension.
- D. Diarrhea related to dopaminergic effects.
Correct Answer: C
Rationale: The correct answer is C, "Risk for injury related to CVS effects and incidence of orthostatic hypotension." This is the most appropriate diagnosis for a patient with Parkinson's Disease because they are at increased risk for falls due to cardiovascular (CVS) effects such as orthostatic hypotension, which can lead to dizziness and falls. This diagnosis addresses the specific risk factor associated with Parkinson's Disease and focuses on preventing potential injuries.
Choice A, "Constipation related to dopaminergic effects," is incorrect as constipation is a common symptom in Parkinson's Disease but does not directly relate to the risk of injury.
Choice B, "Risk for injuries related to CVS effects and PVD," is incorrect because it includes peripheral vascular disease (PVD) which is not typically associated with Parkinson's Disease.
Choice D, "Diarrhea related to dopaminergic effects," is also incorrect as diarrhea is not a common symptom or risk factor for patients with Parkinson's Disease.
The nurse is caring for a patient receiving warfarin and notes bruising and petechiae on the patient's extremities. The nurse will request an order for which?
- A. Vitamin K Level.
- B. PTT and aPTT.
- C. International normalized ratio (INR).
- D. Platelet level.
Correct Answer: C
Rationale: The correct answer is C: International normalized ratio (INR). When a patient on warfarin presents with bruising and petechiae, it suggests potential over-anticoagulation. INR measures the effectiveness of warfarin therapy by assessing clotting time. An elevated INR indicates a higher risk of bleeding due to excessive anticoagulation. Ordering a Vitamin K level (choice A) is not necessary as the patient is already on warfarin. PTT and aPTT (choice B) are not specific to monitoring warfarin therapy. Platelet level (choice D) is not indicated for assessing warfarin effects.
A patient who has Parkinson's will begin taking carbidopa-levodopa. What information will the nurse include when teaching this patient about this medication?
- A. Discontinue the drug if you experience insomnia.
- B. Rise slowly from your bed or chair to avoid dizziness and falls.
- C. Call your health care provider immediately if your urine turns a dark color.
- D. Take the drug with foods high in protein to improve drug delivery.
Correct Answer: B
Rationale: The correct answer is B: Rise slowly from your bed or chair to avoid dizziness and falls. This is because carbidopa-levodopa can cause orthostatic hypotension, leading to dizziness and potential falls when standing up quickly. Instructing the patient to rise slowly can help prevent this adverse effect.
Choice A is incorrect because insomnia is not a common side effect of carbidopa-levodopa, so there is no need to discontinue the drug solely for this reason.
Choice C is incorrect as dark-colored urine is not a typical side effect of carbidopa-levodopa and does not warrant immediate medical attention.
Choice D is incorrect because taking carbidopa-levodopa with high-protein foods can actually decrease the absorption of the medication, potentially reducing its effectiveness.
Therefore, the most important information for the patient to remember is to rise slowly to prevent dizziness and falls.
What class of antiarrhythmic drugs blocks potassium channels prolonging phase 3 of the action potential and slowing the rate and conduction of the heart?
- A. I.
- B. IV.
- C. III.
- D. II.
Correct Answer: C
Rationale: The correct answer is C: Class III. Class III antiarrhythmic drugs block potassium channels, which prolongs phase 3 of the action potential by delaying repolarization. This action results in a longer refractory period, slowing the heart rate and conduction. Option A (Class I) blocks sodium channels, option B (Class IV) blocks calcium channels, and option D (Class II) are beta-blockers that work by blocking beta-adrenergic receptors. These classes do not have a direct effect on potassium channels and do not produce the same effect as Class III drugs.