Nokea
Propranolol is contraindicated in:
- A. Angina pectoris
- B. Bronchial asthma
- C. Hypertension
- D. Arrhythmia
Correct Answer: B
Rationale: Propranolol is a non-selective beta-blocker that can cause bronchoconstriction, making it contraindicated in bronchial asthma. It can worsen asthma symptoms by blocking beta-2 receptors in the lungs. Angina pectoris, hypertension, and arrhythmia are conditions where propranolol is commonly used due to its beta-blocking effects on the heart and blood vessels.
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A patient with a recent drug poisoning is transported to the emergency department. The physician orders (correctly, in this case) administration of pralidoxime as part of the comprehensive emergency treatment plan. Which one of the following best describes who the patient was?
- A. A 13-year-old boy who took an overdose of amphetamine for his ADD/ADHD
- B. A 43-year-old who took an overdose of neostigmine, prescribed for her myasthenia gravis, in a suicide attempt
- C. A 6-year-old who got into the family medicine cabinet and took 10 'adult doses' of her dad's prazosin
- D. A farm/field worker accidentally doused with insecticide from an overflying crop-duster plane
Correct Answer: D
Rationale: The correct answer is D because pralidoxime is used to treat poisoning from organophosphate insecticides, which are commonly used in agriculture. The patient is likely a farm/field worker who was accidentally exposed to insecticide.
A: Amphetamine poisoning does not require pralidoxime.
B: Neostigmine is not an organophosphate insecticide.
C: Prazosin is not an organophosphate insecticide and is unlikely to require pralidoxime in this context.
In summary, the correct answer is D because the patient's exposure to insecticide aligns with the indication for pralidoxime use, while the other choices involve different substances that do not require pralidoxime treatment.
A patient with hypothyroidism is treated with levothyroxine (Synthroid). What should the nurse include when teaching the patient about this therapy?
- A. Explain that alternate-day dosage may be used if side effects occur.
- B. Provide written instruction for all information related to the drug therapy.
- C. Assure the patient that a return to normal function will occur with replacement therapy.
- D. Inform the patient that the drug must be taken until the hormone balance is reestablished.
Correct Answer: B
Rationale: Providing written instructions helps ensure the patient understands the treatment plan, including correct dosage, administration, and any potential side effects.
Mrs. Klein, aged 35 years, has just been diagnosed as diabetic. She is being put on a 1200 calorie diabetic diet with 50% of the calories to be from carbohydrates, 20% from protein, and 30% from fat. In instructing her about her diet, which of the following would be the best breakfast to suggest?
- A. Three waffles with butter, dietetic syrup, coffee
- B. One boiled egg, corn flakes with one glass milk, coffee, glass of orange juice
- C. A cheese omelet (4 oz cheddar, three eggs), one slice toast, one glass milk
- D. Two buttered English muffins, glass of grapefruit juice, coffee
Correct Answer: C
Rationale: A cheese omelet with protein and appropriate carbohydrate content fits the macronutrient distribution for a diabetic diet.
We want to prescribe scopolamine, as a transdermal drug delivery system (skin patch), for a patient who will be leaving for an expensive cruise and is very susceptible to motion sickness. For which of the following co-morbidities is scopolamine contraindicated?
- A. Angle-closure (narrow-angle) glaucoma
- B. Bradycardia
- C. History of shellfish allergies
- D. Resting blood pressure of 112/70
Correct Answer: A
Rationale: The correct answer is A: Angle-closure (narrow-angle) glaucoma. Scopolamine, an anticholinergic medication, can worsen angle-closure glaucoma by causing pupil dilation leading to increased intraocular pressure. This can result in a sudden and severe increase in eye pressure, leading to potential vision loss. Therefore, it is contraindicated in patients with narrow-angle glaucoma.
B: Bradycardia is not a contraindication for scopolamine use as it may actually help in treating motion sickness.
C: History of shellfish allergies is not a contraindication for scopolamine as the medication is not derived from shellfish and is safe for patients with this allergy.
D: Resting blood pressure of 112/70 is not a contraindication for scopolamine use as it falls within the normal range and should not pose any significant risk.
Complete the following sentence: Antidiuretic hormone is secreted from the…
- A. Adrenal cortex
- B. Thyroid gland
- C. Pancreas
- D. Posterior pituitary gland
Correct Answer: D
Rationale: The correct answer is D: Posterior pituitary gland. Antidiuretic hormone (ADH), also known as vasopressin, is produced in the hypothalamus and then transported to the posterior pituitary gland for secretion into the bloodstream. ADH plays a key role in regulating water balance by controlling the reabsorption of water in the kidneys. Choices A, B, and C are incorrect as they are not the primary sites of ADH production and secretion. The adrenal cortex produces hormones like cortisol and aldosterone, the thyroid gland produces hormones like thyroxine, and the pancreas produces insulin and glucagon.