Nokea
In the presence of pentazocine, a higher concentration of morphine is required to elicit pain relief. Pentazocine by it self has a smaller analgesic effect than does morphine, even at the highest dose, Which of the following is correct regarding these medications?
- A. Pentazocine is a competitive antagonist
- B. Morphine is a full agonist, and pentazocine is a partial agonist
- C. Morphine is less efficacious than is pentazocine
- D. Morphine is less potent than is pentazocine
Correct Answer: B
Rationale: Pentazocine's submaximal effect and antagonism of morphine indicate it is a partial agonist, while morphine is a full agonist.
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A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients?
- A. A client at 8 weeks of gestation who asks for an influenza immunization
- B. A client who takes Prednisolone and has a no fungal infection
- C. A client who has chronic liver disease and is taking hydrocortone
- D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide
Correct Answer: C
Rationale: Prednisolone worsens fungal infections, hydrocortisone is risky in liver disease, and warfarin with pregnancy increases bleeding risk.
A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
- A. The impact of the placebo effect on the patients response.
- B. The accumulative effect of the drug if it has been taken for many years.
- C. The impact of the warmer environment on the patients physical status.
- D. Problems with patient compliance with the drug regimen while on vacation.
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and moves to a warmer climate, there is a chance that the patients blood pressure will drop too low, resulting in dizziness and feelings of weakness. Even mild dehydration could exacerbate these effects. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied:
- A. Immediately before swimming
- B. 15 minutes before exposure to the sun
- C. Immediately before exposure to the sun
- D. At least 30 minutes before exposure to the sun
Correct Answer: D
Rationale: Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
Which of the following is natural mineralcorticoid:
- A. Methylprednisolone
- B. Betamethasone
- C. Triamcinolone
- D. Aldosterone
Correct Answer: D
Rationale: Aldosterone is the primary natural mineralocorticoid, regulating sodium and potassium balance.
Serum digoxin levels are monitored for potential toxicity. Monitoring should occur:
- A. Within 6 hours of the last dose
- B. Because a reference point is needed in adjusting a dose
- C. After three half-lives from the starting of the drug
- D. When a patient has stable renal function
Correct Answer: C
Rationale: Monitoring after three half-lives (steady state) ensures accurate therapeutic levels.