Prototype of narcotic analgesic agents:
- A. morphine
- B. codeine
- C. heroin
- D. meperidine
Correct Answer: A
Rationale: Morphine is the prototype of narcotic analgesic agents. It is a strong opioid analgesic that is commonly used for the relief of severe pain. Morphine acts on the central nervous system to reduce the perception of pain and is often used in medical settings, such as hospitals, to manage post-operative pain or pain associated with certain medical conditions like cancer. Other opioids, such as codeine, heroin, meperidine, and oxycodone, are derived from or related to morphine but may have different or varying levels of potency, side effects, and addiction potential.
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A patient is receiving an IV infusion of heparin and was started on warfarin therapy the night
- A. Which statement is most correct?
- B. The patient is receiving a double dose of anticoagulants.
- C. The heparin therapy was ineffective, so the warfarin was starte
- D. The heparin provides anticoagulation until therapeutic levels of warfarin are reache
Correct Answer: D
Rationale: The correct statement is that the heparin provides anticoagulation until therapeutic levels of warfarin are reached. Heparin and warfarin are both anticoagulants but work in different ways. Heparin acts quickly to prevent blood clot formation while warfarin takes several days to reach its full effect. Therefore, heparin is often used initially to provide immediate anticoagulation while waiting for the warfarin to reach therapeutic levels. This dual therapy is common in clinical practice to ensure continuous anticoagulation.
The nurse observes a short period of asystole on the cardiac monitor that resolves spontaneously immediately after administering adenosine IV to a patient who was experiencing paroxysmal supraventricular tachycardia. Which initial action is the most appropriate for the nurse?
- A. Call a code to report a cardiac arrest.
- B. Prepare epinephrine and atropine for intravenous administration.
- C. Initiate cardiopulmonary resuscitation (CPR).
- D. Closely observe the patient and the cardiac monitor.
Correct Answer: D
Rationale: Adenosine is used to treat paroxysmal supraventricular tachycardia (PSVT) by temporarily blocking AV node conduction, which can cause a brief period of asystole. This is an expected effect and typically resolves spontaneously. The nurse should closely monitor the patient and the cardiac monitor for the return of a normal rhythm. Calling a code (A), preparing epinephrine and atropine (B), or initiating CPR (C) is unnecessary unless the asystole persists or the patient becomes unstable.
Penicillin's effectiveness against rapidly growing cell is primarily due to its effect on what?
- A. protein synthesis
- B. chelation of metal ions
- C. cell wall synthesis
- D. cell membrane permeability
Correct Answer: C
Rationale: Penicillin is a type of antibiotic that works by disrupting the synthesis of the bacterial cell wall. Bacterial cells have a cell wall that provides structural support and protection. The cell wall is composed of peptidoglycan, a complex molecule that gives the cell wall its strength. Penicillin interferes with the formation of peptidoglycan by inhibiting the enzyme transpeptidase, which is essential for cross-linking the peptidoglycan strands. As a result, bacterial cells become more susceptible to osmotic pressure and eventually burst, leading to their death. This mechanism of action is particularly effective against rapidly growing bacterial cells because they are actively synthesizing new cell wall components to keep up with their growth. Thus, penicillin's primary effectiveness against rapidly growing cells is primarily due to its disruption of cell wall synthesis.
A patient requires a nonopioid medication. The nurse knows that which medication will cause the least gastrointestinal distress?
- A. Aspirin
- B. Ketorolac
- C. Celecoxib
- D. Ibuprofen
Correct Answer: C
Rationale: Celecoxib is a selective COX-2 inhibitor, which means it primarily targets the COX-2 enzyme involved in inflammation and pain while sparing the COX-1 enzyme that protects the stomach lining. This selectivity reduces the risk of gastrointestinal distress, such as ulcers and bleeding, compared to non-selective NSAIDs like aspirin, ketorolac, and ibuprofen. Therefore, celecoxib is the best choice for patients who require a nonopioid medication with minimal gastrointestinal side effects. Nurses should consider this when selecting pain management options for patients with a history of gastrointestinal issues.
What is the pharmacological action of metformin?
- A. Biguanides
- B. Benzodiazepines
- C. Nitrates
- D. Digitalis glycosides
Correct Answer: A
Rationale: Metformin belongs to the class of medications known as biguanides. Biguanides work by decreasing glucose production in the liver and also improving insulin sensitivity in the muscles, helping to lower blood sugar levels in patients with type 2 diabetes. Additionally, metformin can also reduce glucose absorption in the intestines and increase glucose uptake in peripheral tissues. Its main pharmacological action is to improve glycemic control and reduce hyperglycemia in patients with diabetes.
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