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 .
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A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take?
- A. Use a disposable razor to remove excess hair on the extremity.
- B. Select the back of the client's hand to the catheter.
- C. Entered the veins by using a blood pressure cuff.
- D. Direct the client to raise his arm above his heart
Correct Answer: B
Rationale: The back of the hand is a common site for older adults due to accessible veins and reduced risk of complications.
A contraindication for topical corticosteroid usage in a male with atopic dermatitis (eczema) is:
- A. Parasite infection
- B. Viral infection
- C. Bacterial infection
- D. Spirochete infection
Correct Answer: B
Rationale: Topical corticosteroids worsen viral infections (e.g., herpes) due to immunosuppression.
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.
Which of the following is the indication for glucocorticoid prescribing?
- A. Cataract
- B. Prevention of respiratory distress
- C. Hypofunction of thyroid gland
- D. Hypocalcemia
Correct Answer: B
Rationale: Glucocorticoids are indicated to prevent respiratory distress, such as in preterm infants for lung maturation.
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.