Nokea
Recent studies into the pathogenesis of halothane-induced malignant hyperthermia indicate which of the following as the likely implicating cause?
- A. Drug toxicity
- B. Excitation-contraction coupling defect
- C. Myoplasmic sodium defect
- D. Oxygen-hemoglobin concentration deficit
Correct Answer: B
Rationale: Malignant hyperthermia (MH) from halothane involves excitation-contraction coupling defects . MH, a genetic disorder, stems from ryanodine receptor (RYR1) mutations, causing uncontrolled calcium release in muscle, not drug toxicity . Sodium defects , oxygen deficits , or neural overmodulation (E) aren't implicated. This coupling defect triggers hypermetabolism, explaining MH's rapid onset with halothane exposure.
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The adolescent is supposed to go to the school nurse at 12:00 to receive his medication for attention-deficit hyperactivity disorder (ADHD). He often does not go for the medication. What best describes the nurse's understanding of this situation?
- A. The adolescent is embarrassed in front of his peers
- B. The adolescent does not understand the need for the medication
- C. The adolescent forgets that he is supposed to take the medication
- D. The adolescent has made a conscious decision not to take the medication
Correct Answer: A
Rationale: Adolescents prioritize peer image-skipping ADHD meds (e.g., Ritalin) at school likely stems from embarrassment, a developmental trait. Lack of understanding or forgetting is possible but less likely with routine. Conscious refusal needs evidence (e.g., verbal rejection). Embarrassment fits social sensitivity, guiding intervention.
A client calls the clinic and tells the nurse that she has missed taking several of her contraceptive pills during the current cycle. What is the best instruction for the nurse to give the client?
- A. Please come into the clinic immediately to have a pregnancy test done.'
- B. You might consider another form of birth control if you keep missing your pills.'
- C. If you have missed fewer than three of your pills, you do not need to worry.'
- D. You should use an alternative form of birth control for the rest of this cycle.'
Correct Answer: D
Rationale: Missing several contraceptive pills compromises efficacy, requiring an alternative method for the cycle to prevent pregnancy. Testing assesses outcome, not prevention. Future methods don't address now. Fewer than three still risks failure. D ensures immediate protection, making it the best instruction.
A healthcare professional is preparing to administer verapamil by IV bolus to a client who is experiencing cardiac dysrhythmias. For which of the following adverse effects should the healthcare professional monitor when giving this medication?
- A. Hyperthermia
- B. Hypotension
- C. Ototoxicity
- D. Muscle pain
Correct Answer: B
Rationale: Verapamil is known to cause hypotension as one of its adverse effects due to its vasodilatory properties. Therefore, it is essential for the healthcare professional to monitor the client's blood pressure closely during and after administration to prevent complications such as severe hypotension. Hyperthermia, ototoxicity, and muscle pain are not commonly associated with verapamil administration, making choices A, C, and D incorrect.
A client has a new prescription for Hydralazine. Which of the following side effects should the nurse instruct the client to monitor for and report?
- A. Orthostatic hypotension
- B. Increased heart rate
- C. Dark-colored urine
- D. Persistent cough
Correct Answer: B
Rationale: Corrected Rationale: Hydralazine, a vasodilator, can cause reflex tachycardia, leading to an increased heart rate. This side effect should be reported to the healthcare provider to ensure appropriate management and monitoring of the client's condition. Choice A (Orthostatic hypotension) is incorrect as Hydralazine is more likely to cause reflex tachycardia than orthostatic hypotension. Choice C (Dark-colored urine) and Choice D (Persistent cough) are unrelated to the common side effects of Hydralazine and should not be the focus of monitoring for this medication.
Which drug is the antidote for Alprazolam?
- A. Physostigmine
- B. Protamine sulfate
- C. Flumazenil
- D. Acetylcysteine
Correct Answer: C
Rationale: Flumazenil is the specific antidote used to reverse the effects of Alprazolam. Alprazolam is a benzodiazepine, and Flumazenil is a benzodiazepine receptor antagonist that works by competitively inhibiting the actions of benzodiazepines at the receptor site, effectively reversing their sedative and other effects. Physostigmine is not used as an antidote for benzodiazepine overdose and can have significant side effects. Protamine sulfate is used to reverse the effects of heparin, not benzodiazepines like Alprazolam. Acetylcysteine is used as an antidote for acetaminophen overdose, not benzodiazepines like Alprazolam.