Nokea
Patients who are beginning therapy with vitamin B12 need to be monitored for:
- A. Hypertensive crisis that may occur in the first 36 hours
- B. Hypokalemia that occurs in the first 48 hours
- C. Leukopenia that occurs at 1 to 3 weeks of therapy
- D. Thrombocytopenia that may occur at any time in therapy
Correct Answer: B
Rationale: Hypokalemia can occur early in B12 therapy as red cell production surges, shifting potassium; other effects are rare.
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The nurse is caring for a patient who is chronically irritable and anxious and prone to violent behaviors. The patient has several teeth missing and has dental caries in the remaining teeth. The nurse suspects previous chronic use of which drug?
- A. Alcohol
- B. Cocaine
- C. LSD
- D. Methamphetamine
Correct Answer: D
Rationale: Methamphetamine causes tooth decay ('meth mouth') and agitation; cocaine less so. Patients previously exposed to methamphetamine use will exhibit these symptoms, and the physical effects of extended methamphetamine use are notable tooth decay and dermatologic deterioration.
Nicotine gum products are:
- A. Chewed to release the nicotine and then swallowed for a systemic effect
- B. Parked' in the buccal area of the mouth to produce a constant amount of nicotine release
- C. Bound to exchange resins so the nicotine is only released during chewing
- D. Approximately the same in nicotine content as smoking two cigarettes
Correct Answer: B
Rationale: Nicotine gum is parked buccally for steady release.
Aminoglycosides lack activity against streptococci.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: Aminoglycosides are effective against some streptococci (e.g., when combined with cell wall-active agents), though they are primarily used for gram-negative bacteria.
Taylor is a 10-year-old child diagnosed with major depression. The appropriate first-line antidepressant for children is:
- A. Fluoxetine
- B. Fluvoxamine
- C. Sertraline
- D. Escitalopram
Correct Answer: A
Rationale: Fluoxetine is FDA-approved as a first-line treatment for pediatric depression.
Which person should be treated with prophylactic antitubercular medication?
- A. A child who attends the same school with a child who has tuberculosis
- B. A nurse who is working in a hospital
- C. An individual who is HIV-positive with a negative TB skin test
- D. A patient who has close contact with someone who has tuberculosis
Correct Answer: D
Rationale: Close contact with TB warrants prophylaxis; school , hospital work , or HIV without exposure don't. Personal contact with a person having a diagnosis of tuberculosis is required to indicate prophylactic treatment with antitubercular therapy.