Nokea
The client is taking a class IB anti-arrhythmic drug. What drug might that be?
- A. Lidocaine
- B. Procainamide
- C. Mexiletine
- D. Metoprolol
Correct Answer: A
Rationale: Lidocaine is a class IB agent, effective for ventricular arrhythmias, with minimal effect on action potential duration.
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Barbiturates increase the rate of metabolism of:
- A. Anticoagulants
- B. Digitalis compounds
- C. Glucocorticoids
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Barbiturates are known to increase the metabolism of various drugs, including anticoagulants, digitalis compounds, and glucocorticoids. This is because barbiturates induce liver enzymes responsible for drug metabolism, leading to faster clearance of these medications from the body. Therefore, the correct answer is D as barbiturates can affect the metabolism of all the mentioned drug classes. Choices A, B, and C are incorrect as barbiturates do not selectively increase the metabolism of only one of these drug classes, but rather have a broad impact on drug metabolism.
While completing the history portion of an admission assessment of a client with schizophrenia, the nurse notices that the client is continually moving in the chair and frequently stands, then sits back down. The nurse knows that this client most likely is experiencing the side effect of:
- A. Drug-induced parkinsonism
- B. Dystonia
- C. Akathisia
- D. Akinesia
Correct Answer: C
Rationale: The correct answer is C: Akathisia. Akathisia is characterized by restlessness, inability to sit still, and a constant need to move. In this scenario, the client's continual movement and inability to sit still indicate symptoms of akathisia. This side effect is commonly seen with antipsychotic medications.
Explanation:
1. Drug-induced parkinsonism (Choice A) presents with symptoms similar to Parkinson's disease, such as tremors, stiffness, and shuffling gait. The client's symptoms do not align with these characteristics.
2. Dystonia (Choice B) is characterized by involuntary muscle contractions causing abnormal movements or postures. The client's symptoms do not match the sudden, sustained muscle contractions seen in dystonia.
3. Akinesia (Choice D) refers to a lack of movement or difficulty initiating movement, which is not consistent with the client's behavior of constant movement and inability to sit still.
A patient has not come out of her room for breakfast. The nurse finds the patient moving restlessly about her room in a disorganized manner. The patient is talking to herself, and her verbal responses to the nurse are nonsensical and suggest disorientation. The nurse notices that the patient’s skin is hot and dry, and her pupils are somewhat dilated. All these symptoms are significant departures from the patient’s recent presentation. The patient is likely experiencing ________ , and the nurse should ___________.
- A. anticholinergic toxicity…check vital signs and prepare to use a cooling blanket stat
- B. relapse of her psychosis…administer PRN antipsychotic drugs and notify her physician
- C. neuroleptic malignant syndrome…contact her physician for a transfer to intensive care
- D. agranulocytosis…hold her antipsychotic and draw blood for a complete blood count
Correct Answer: A
Rationale: The correct answer is A: anticholinergic toxicity. The patient's symptoms (restlessness, disorganized movement, nonsensical speech, disorientation, hot and dry skin, dilated pupils) are indicative of anticholinergic toxicity. Anticholinergic medications can cause these symptoms by blocking the action of acetylcholine in the brain and body. The nurse should check vital signs and prepare to use a cooling blanket to lower the patient's body temperature, as anticholinergic toxicity can lead to hyperthermia.
Choice B (relapse of psychosis) is incorrect because the symptoms are not typical of a simple relapse of psychosis. Choice C (neuroleptic malignant syndrome) is incorrect because the symptoms do not match the classic presentation of neuroleptic malignant syndrome, which includes fever, muscle rigidity, and altered mental status. Choice D (agranulocytosis) is incorrect because the symptoms are not consistent with agranulocytosis,
A patient has been taking temazepam (Restoril) for intermittent insomnia. She calls the nurse to say that when she takes it, she sleeps well, but the next day she feels 'so tired.' Which explanation by the nurse is correct?
- A. “Long-term use of this drug results in a sedative effect.”
- B. “If you take the drug every night, this hangover effect will be reduced.”
- C. “These drugs affect the sleep cycle, resulting in daytime sleepiness.”
- D. “These drugs increase the activity of the central nervous system (CNS), making you tired the next day.”
Correct Answer: C
Rationale: The correct answer is C: “These drugs affect the sleep cycle, resulting in daytime sleepiness.” Temazepam is a benzodiazepine used for insomnia by enhancing the effects of GABA neurotransmitter, which can disrupt the sleep cycle. This disruption can lead to next-day drowsiness. Choice A is incorrect as long-term use does not increase sedative effects. Choice B is incorrect as taking the drug regularly may not reduce the hangover effect. Choice D is incorrect as benzodiazepines like temazepam actually have a sedative effect and do not increase CNS activity.
Indicate the side effect of Theophylline:
- A. Bradycardia
- B. Increased myocardial demands for oxygen
- C. Depression of respiratory centre
- D. Elevation of the arterial blood pressure
Correct Answer: B
Rationale: The correct answer is B: Increased myocardial demands for oxygen. Theophylline is a bronchodilator that works by relaxing the smooth muscles in the airways. This relaxation can lead to increased heart rate and contractility, causing the heart to work harder and increasing its demand for oxygen. Bradycardia (choice A) is not a common side effect of Theophylline. Depression of the respiratory center (choice C) is also not a typical side effect, as Theophylline is a respiratory stimulant. Elevation of arterial blood pressure (choice D) is not directly caused by Theophylline but can occur as a secondary effect due to increased heart rate and contractility.