Nokea
In choosing a benzodiazepam to treat anxiety the prescriber needs to be aware of the possibility of dependence. The benzodiazepam with the greatest likelihood of rapidly developing dependence is:
- A. Chlordiazepoxide (Librium)
- B. Clonazepam (Klonopin)
- C. Alprazolam (Xanax)
- D. Oxazepam (Serax)
Correct Answer: C
Rationale: Alprazolam's short half-life increases dependence risk.
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Which of the following is a biguanides which is used for the treatment of diabetes mellitus type II:
- A. Repaglinide
- B. Glibenclamide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin is the primary biguanide used for type 2 diabetes, reducing hepatic glucose production and improving insulin sensitivity.
A 68-year-old patient who must take antihistamines for severe allergies is planning a vacation to Mexico. The nurse will encourage the patient to:
- A. Avoid sightseeing during the hottest part of the day
- B. Discontinue the antihistamines if he becomes extremely restless
- C. Decrease the dosage of the drugs if he experiences excessive thirst
- D. Continue taking the antihistamines even if he begins to hallucinate
Correct Answer: A
Rationale: Antihistamines can decrease sweating by blocking cholinergic receptors, placing the patient at high risk for heat stroke. Avoiding the hottest part of the day will help prevent dehydration and heat prostration. Extreme restlessness could indicate Parkinson-like syndrome not usually associated with antihistamines. Excessive thirst is characteristic of hyperglycemia, and hallucinations are associated with drugs that affect neurologic functioning. Nurses should never tell patients to decrease or discontinue a drug unless the prescriber has instructed them to do so.
A pharmacology student asks the instructor what an accurate description of a drug agonist is. What is the instructors best response?
- A. A drug that reacts with a receptor site on a cell preventing a reaction with another chemical on a different receptor site
- B. A drug that interferes with the enzyme systems that act as catalyst for different chemical reactions
- C. A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site
- D. A drug that reacts with receptor sites to block normal stimulation, producing no effect
Correct Answer: C
Rationale: Agonists are drugs that produce effects similar to those produced by naturally occurring neurotransmitters, hormones, or other substances found in the body. Noncompetitive antagonists are drugs that react with some receptor sites preventing the reaction of another chemical with a different receptor site. Drug-enzyme interactions interfere with the enzyme systems that stimulate various chemical reactions.
The nurse is teaching a patient who will be discharged home with naltrexone (ReVia) after treatment for opioid addiction. What information will the nurse include in the teaching for this patient?
- A. This drug will help control cravings
- B. You may take this drug once weekly
- C. ReVia blocks the pleasurable effects of opioids
- D. If you discontinue this drug abruptly, you will have withdrawal symptoms
Correct Answer: C
Rationale: Naltrexone blocks opioid euphoria; it doesn't reduce cravings or cause withdrawal on stop . ReVia acts by blocking the pleasurable effects of opioids.
The nurse is preparing to administer a medication from a multidose bottle. The label is torn and soiled but the name of the medication is still readable. What is the nurses priority action?
- A. Discard the entire bottle and contents and obtain a new bottle.
- B. Find the drug information and create a new label for the bottle.
- C. Ask another nurse to verify the contents of the bottle.
- D. Administer the medication if the name of the drug can be clearly read.
Correct Answer: A
Rationale: When the drug label is soiled obscuring some information the safest action by the nurse is to discard the bottle and contents because drug labels contain a great deal of important information, far more than just the name of the drug. Concentration of the drug, expiration date, administration directions, and precautions may be missing from the label and so put the patient at risk. Looking up drug information in a drug handbook or consulting with another nurse will not supply the expiration date or concentration of medication. Be safe and discard the bottle and its contents.