Nokea
In the presence of naloxone, a higher concentration of morphine is required to elicit full pain relief. Naloxone by it self has no effect. Which of the following is correct regarding these medications?
- A. Naloxone is a competitive antagonist
- B. Morphine is a full agonist, and naloxone is a partial agonist
- C. Morphine is less efficacious than is naloxone
- D. Morphine is less potent than is naloxone
Correct Answer: A
Rationale: Naloxone shifts morphine's dose-response curve rightward (increased EC50), typical of competitive antagonism, with no intrinsic effect.
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The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin, and streptomycin reviews the medical record and notes the patient's sputum cultures reveal resistance to streptomycin. The nurse will expect the provider to order which drug?
- A. Isoniazid (INH)
- B. Pyrazinamide
- C. Rifampin (Rifadin)
- D. Streptomycin
Correct Answer: A
Rationale: INH is the prophylactic standard for TB contacts; other drugs aren't typically used alone for this. INH is the drug of choice for prophylactic treatment of patients who have had close contact with a patient who has tuberculosis.
Zero order kinetics are seen in all except
- A. Salicylate
- B. Atenolol
- C. Barbiturates
- D. Ethanol
Correct Answer: C
Rationale: Barbiturates typically follow first-order kinetics; others exhibit zero-order at high doses.
Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?
- A. Tinnitus
- B. Diarrhea
- C. Constipation
- D. Decreased respirations
Correct Answer: A
Rationale: Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism.
Both men and women experience bone loss with aging. The bones most likely to demonstrate significant loss are:
- A. Cortical bones
- B. Femoral neck bones
- C. Cervical vertebrae
- D. Pelvic bones
Correct Answer: B
Rationale: Femoral neck is a trabecular bone site prone to significant age-related loss, unlike cortical or other areas .
A nurse is teaching the parents of a child who has a new prescription for Desipramine. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider?
- A. Constipation
- B. Suicidal thoughts
- C. Photophobia
- D. Dry mouth
Correct Answer: B
Rationale: Suicidal thoughts are a critical adverse effect of tricyclics like desipramine, requiring immediate reporting.