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Jake, a 45-year-old patient with schizophrenia, was recently hospitalized for acute psychosis due to medication noncompliance. He was treated with IM long-acting haloperidol. Besides monitoring his schizophrenia symptoms, the patient should be assessed by his primary care provider:
- A. For excessive weight loss
- B. With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS)
- C. Monthly for tolerance to the haloperidol
- D. Only by the mental health provider, as most NPs in primary care do not care for mentally ill patients
Correct Answer: B
Rationale: Haloperidol can cause EPS, monitored using the AIMS.
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James has hypothalamic-pituitary-adrenal axis suppression from chronic prednisone (a corticosteroid) use. He is at risk for what type of adverse drug reaction?
- A. Type B
- B. Type C
- C. Type E
- D. Type F
Correct Answer: B
Rationale: Chronic prednisone use causing HPA suppression is a Type C (chronic) ADR , linked to prolonged exposure, not idiosyncratic , withdrawal , or failure .
A nurse is caring for a client who is prescribed Isosorbide Mononitrate for chronic stable Angina and develops reflex tachycardia. Which of the following medications should the nurse expect to administer?
- A. Furosemide
- B. Captopril
- C. Ranolazine
- D. Metoprolol
Correct Answer: D
Rationale: Metoprolol , a beta-blocker, treats reflex tachycardia by slowing heart rate.
A patient arrives in the emergency department in an acute state of alcohol intoxication and reports chronic consumption of several six packs of beer every day for the past year. The nurse anticipates administering which medication or treatment?
- A. Chlordiazepoxide (Librium)
- B. Disulfiram (Antabuse)
- C. Gastric lavage
- D. Vasoconstrictors
Correct Answer: A
Rationale: Chlordiazepoxide prevents alcohol withdrawal symptoms; disulfiram is post-detox. To prevent acute withdrawal and delirium tremens, a long-acting benzodiazepine, such as chlordiazepoxide, is given.
Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it:
- A. Increases peripheral vasoconstriction
- B. Decreases detrusor muscle contractility
- C. Lowers supine blood pressure more than standing pressure
- D. Relaxes smooth muscle in the bladder neck
Correct Answer: D
Rationale: Doxazosin, an alpha-1 blocker, relaxes bladder neck smooth muscle, aiding BPH, and lowers blood pressure.
Cholinergic blockers are used to:
- A. Counteract the extrapyramidal symptoms (EPS) effects of phenothiazines
- B. Control tremors and relax smooth muscle in Parkinson's disease
- C. Inhibit the muscarinic action of ACh on bladder muscle
- D. All of the above
Correct Answer: D
Rationale: Cholinergic blockers address EPS, Parkinson's symptoms, and bladder overactivity.