Nokea
Josie is a 5-year-old patient who presents to the clinic with a 48-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down and her weight is 4 pounds less than her last recorded weight. Besides IV fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie?
- A. Prochlorperazine (Compazine)
- B. Meclizine (Antivert)
- C. Promethazine (Phenergan)
- D. Ondansetron (Zofran)
Correct Answer: D
Rationale: Ondansetron is preferred in kids for nausea/vomiting, with fewer side effects than prochlorperazine or promethazine ; meclizine is for motion sickness.
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Chlorpromazine can block following receptors EXCEPT:
- A. Dopamine
- B. Beta adrenergic
- C. Alpha adrenergic
- D. Muscarinic
Correct Answer: B
Rationale: Chlorpromazine, a typical antipsychotic, blocks dopamine, alpha-adrenergic, and muscarinic receptors but has minimal effect on beta-adrenergic receptors, which are not its primary target.
A nurse is teaching a client who has Graves' disease about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?
- A. Propranolol helps increase blood flow to my thyroid gland.
- B. Propranolol is used to prevent excess glucose in my blood.
- C. Propranolol will decrease my tremors and fast heart beat.
- D. Propranolol promotes a decrease of thyroid hormone in my body
Correct Answer: C
Rationale: Propranolol reduces tremors and tachycardia in Graves' disease by blocking beta-adrenergic effects.
While caring for a patient with a history of hypothyroidism, the nurse expects which of the following medications to be included in the patient's medication list?
- A. Levothyroxine sodium (Synthroid)
- B. Estrogen (Estradiol)
- C. Iodine 131
- D. Carbimazole (Methimazole)
Correct Answer: A
Rationale: Levothyroxine (Synthroid) is the standard treatment for hypothyroidism, replacing thyroid hormone; carbimazole treats hyperthyroidism, and iodine 131 is for ablation.
A nurse is administering a Dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication?
- A. Lowered heart rate
- B. Increased myocardial contractility
- C. Decreased conduction through the AV node
- D. Vasoconstriction of renal blood vessel
Correct Answer: B
Rationale: Low-dose dopamine increases contractility via beta-adrenergic effects, improving cardiac output.
In which of the following patients would a nurse expect to see an alteration in drug metabolism?
- A. A 35-year-old female with cervical cancer
- B. A 41-year-old male with kidney stones
- C. A 50-year-old male with cirrhosis of the liver
- D. A 62-year-old female in acute renal failure
Correct Answer: C
Rationale: The liver is the most important site of drug metabolism. If the liver is not functioning effectively, as in patients with cirrhosis, drugs will not be metabolized normally and toxic levels could develop. In cirrhosis patients the drug dosage will need to be altered to ensure normal levels in the body.