Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling depressed and having 'strange' thoughts. The appropriate initial action would be:
- A. Increase her dose
- B. Assess for suicidal ideation
- C. Discontinue the medication immediately
- D. Decrease her dose to half then slowly titrate up the dose
Correct Answer: B
Rationale: Gabapentin can cause mood changes; assessing for suicidal ideation is the priority.
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What is the most likely mechanism for hip fracture in patients with glucocorticoid longterm treatment?
- A. Increased intestinal calcium absorption
- B. Increased sex hormone synthesis
- C. Inhibition of bone formation
- D. Osteoarthritis
Correct Answer: C
Rationale: Glucocorticoids inhibit bone formation by suppressing osteoblast activity, increasing osteoporosis and fracture risk.
Tianeptin is
- A. 5-HT antagonist
- B. Nor adrenaline uptake inhibitor
- C. 5-HT reuptake enhancer
- D. Dopamine antagonist
Correct Answer: C
Rationale: Tianeptin enhances serotonin reuptake, unlike typical SSRIs.
The following drug is used for diabetic coma:
- A. Glibenclamid
- B. Long acting insulin preparations
- C. The rapid and intermediate acting insulin preparations
- D. Metformin
Correct Answer: C
Rationale: Rapid and intermediate-acting insulins are used to quickly correct hyperglycemia in diabetic coma.
No physical dependence is seen in:
- A. Dextropropoxyphene
- B. Fortwin
- C. Fluoxetine
- D. Alprax
Correct Answer: C
Rationale: Fluoxetine (SSRI) has no physical dependence; others do.
A nurse is required to give an intramuscular (IM) injection to an 18-month-old toddler. The nurse would prepare which site for administration?
- A. Dorsogluteal site
- B. Deltoid muscle
- C. Vastus lateralis
- D. Ventrogluteal site
Correct Answer: C
Rationale: The vastus lateralis site is frequently used for infants and small children because it is more developed than the other intramuscular sites such as the dorsogluteal and deltoid muscle. Ventrogluteal sites may be used in children who have been ambulating for more than 2 years.