Nokea
Josefina is a 2-year-old child with acute otitis media and an upper respiratory infection. Along with an antibiotic she receives a recommendation to treat the ear pain with ibuprofen. What education would her parent need regarding ibuprofen?
- A. They can cut an adult ibuprofen tablet in half to give Josefina
- B. The ibuprofen dose can be doubled for severe pain
- C. Josefina needs to be well-hydrated while taking ibuprofen
- D. Ibuprofen is completely safe in children with no known adverse effects
Correct Answer: C
Rationale: Hydration reduces ibuprofen's renal risk in kids; cutting tablets or doubling is unsafe.
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The nurse transcribes an order to administer Valium 10 mg IV stat. This order is correctly interpreted by the nurse to mean it should be provided how? (Select all that apply.)
- A. As needed
- B. Immediately
- C. One time only
- D. Intravenously
Correct Answer: D
Rationale: The stat order is generally used on an emergency basis. It means that the drug is to be administered as soon as possible, but only once. IV indicates the route is intravenous. A PRN order means administer if needed. The order would specify divided doses and amount per dose if indicated.
A 57-year-old man was recently diagnosed with Type-2 diabetes mellitus and placed on a medication. He began having myalgias and feeling sick and later developed respiratory distress, so he went to the hospital. His pH was 7.2, and he had elevated blood lactate levels. Which drug is likely causing his problem?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin can cause lactic acidosis, a rare but serious side effect, presenting with low pH and elevated lactate levels.
Which of the following adverse effects of chronic high-dose prednisone administration represents a mineralocorticoid effect?
- A. Buffalo hump
- B. Easy bruising
- C. Edema
- D. Moon facies
Correct Answer: C
Rationale: Edema is a mineralocorticoid effect of prednisone due to sodium and water retention.
If the measles, mumps, rubella, and varicella (MMRV) combined vaccine is ordered to be given as the first MMR and varicella dose to a child the CDC recommends:
- A. Parents be informed of the increased risk of fever and febrile seizures over the MMR plus varicella two-shot regimen
- B. Patients must also receive MMRV as the second dose of MMR and varicella in order to build adequate immunity
- C. Patients be premedicated with acetaminophen 15 minutes before the vaccine is given
- D. Patients should not be around pregnant women for the first 48 hours after the vaccine is given
Correct Answer: A
Rationale: MMRV has higher fever/seizure risk vs. separate shots, per CDC; second dose isn't mandated as MMRV.
A patient is brought to the emergency department after ingesting an overdose of lorazepam (Ativan) several hours prior. The patient has a respiratory rate of 6 to 10 breaths per minute and is unconscious. The nurse will prepare to perform which action?
- A. Administer activated charcoal
- B. Give flumazenil (Romazicon)
- C. Give naloxone (Narcan)
- D. Perform gastric lavage
Correct Answer: B
Rationale: Flumazenil reverses benzodiazepine (lorazepam) overdose; naloxone is for opioids. Flumazenil is the antidote for benzodiazepine overdose.