Nokea
In infants and children, the side effects of first-generation over-the-counter (OTC) antihistamines, such as diphenhydramine (Benedryl) and hydroxyzine (Atarax), can include:
- A. Reye's syndrome.
- B. cholinergic effects.
- C. paradoxical CNS stimulation.
- D. nausea and diarrhea.
Correct Answer: C
Rationale: Typically, first-generation OTC antihistamines have a sedating effect because of passage into the CNS. However, in some individuals, especially infants and children, paradoxical CNS stimulation occurs and is manifested by excitement, euphoria, restlessness, and confusion. For this reason, use of first-generation OTC antihistamines has declined and second-generation product use has increased. Reye's syndrome is a systemic response to a virus. First-generation OTC antihistamines do not exhibit a cholinergic effect. Nausea and diarrhea are uncommon with first-generation OTC antihistamines.
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A client's central venous access device (CVAD) becomes infected. Why might the physician order antibiotics to be given through the line rather than through a peripheral IV line?
- A. to prevent infiltration of the peripheral line
- B. to reduce the pain and discomfort associated with antibiotic administration in a small vein
- C. to lessen the chance of an allergic reaction to the antibiotic
- D. to attempt to eliminate microorganisms in the catheter and prevent having to remove it
Correct Answer: D
Rationale: Microorganisms that infect CVADs are often coagulase-negative staphylococci, which can be eliminated by antibiotic administration through the catheter. If unsuccessful in eliminating the microorganism, the CVAD must be removed. CVAD use lessens the need for peripheral IV lines and thus the risk of infiltration. In this case, however, the antibiotics are given to eradicate microorganisms from the CVAD. CVAD use has the effect described in Choice 2, but in this case, the antibiotics are given through the CVAD to eliminate the infective agent. The route does not prevent an allergic reaction.
A patient that has delivered a 8.2 lb. baby boy 3 days ago via c-section, reports white patches on her breast that aren't going away. Which of the following medications may be necessary?
- A. Nystatin
- B. Atropine
- C. Amoxil
- D. Loritab
Correct Answer: A
Rationale: Thrush, a fungal infection, may be occurring, and Nystatin is an antifungal medication used to treat it.
When medications have an additive, synergistic, or antagonistic effect on a tissue, a reaction has occurred.
- A. Pharmaceutical
- B. Pharmacodynamic
- C. Pharmacokinetic
- D. Drug incompatibility
Correct Answer: B
Rationale: Pharmacodynamic reactions involve the effect of drugs on tissue receptors, causing additive, synergistic, or antagonistic effects.
Metformin (Glucophage) is administered to clients with type II diabetes mellitus. Metformin is an example of:
- A. an antihyperglycemic agent.
- B. a hypoglycemic agent.
- C. an insulin analogue.
- D. a pancreatic alpha cell stimulant.
Correct Answer: A
Rationale: This antihyperglycemic agent prevents hyperglycemia by reducing hepatic glucose output and decreasing glucose absorption from the gut. A hypoglycemic drug stimulates insulin production. Metformin is not a type of insulin. Metformin is not a stimulant of any pancreatic cell.
Which of the following vaccines is a live virus?
- A. varicella
- B. IPV
- C. DTaP
- D. hepatitis B
Correct Answer: A
Rationale: Varicella is a live virus, as is OPV. IPV is an inactivated polio vaccine.