Newborns are at risk for early vitamin K deficiency bleeding and the American Academy of Pediatrics recommends that all newborns receive:
- A. IM vitamin K (phytonadione) within 24 hours of birth
- B. Oral vitamin K supplementation in the first 3 weeks of life
- C. Formula containing vitamin K or breast milk
- D. Oral vitamin K in the first 24 hours after birth
Correct Answer: A
Rationale: IM vitamin K is standard to prevent vitamin K deficiency bleeding in newborns.
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Which of the following drugs is used for the management of atropine intoxication?
- A. Physostigmine
- B. Neostigmine
- C. Endrophonium
- D. Donepezil
Correct Answer: A
Rationale: Physostigmine, a cholinesterase inhibitor, crosses the BBB to reverse atropine's central effects.
Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action?
- A. Notifying the registered nurse
- B. Discontinuing the medication
- C. Informing the client that this is normal
- D. Applying a thinner film than prescribed to the burn site
Correct Answer: C
Rationale: Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat burns to reduce bacteria present in avascular tissues. The client should be informed that the medication will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4 are incorrect.
Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs?
- A. Selective estrogen receptor modulators
- B. Aspirin
- C. Glucocorticoids
- D. Calcium supplements
Correct Answer: C
Rationale: Glucocorticoids cause bone loss, warranting bisphosphonate prophylaxis; SERMs protect bone.
A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take?
- A. Administer the prescribed dose.
- B. Withhold the medication.
- C. Ask the provider to change the prescription to an oral form.
- D. Administer an oral antihistamine at the same time
Correct Answer: B
Rationale: A history of rash suggests a possible allergy; withholding the medication and consulting the provider is safest.
The combination of propranolol & nifedipine in essential hypertension is used because
- A. CNS effects of propanolol are prevented
- B. Pedal edema of nifedipine is prevented
- C. Alteration of serum lipids by propranolol is prevented
- D. Reflex sympathetic activity of nifedipine is prevented
Correct Answer: D
Rationale: Propranolol (beta-blocker) counters nifedipine's (calcium channel blocker) reflex tachycardia.