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The nurse is administering Penicillin to a patient who has tested positive for strep throat. The nurse knows to look for which of the following adverse e昀昀ects as a sign of an acute allergic reaction?
- A. blurred vision
- B. tinnitus
- C. skin rash/hives
- D. vomiting
Correct Answer: C
Rationale: An acute allergic reaction to Penicillin can present with symptoms such as skin rash or hives. This is a common sign of an allergic reaction and can indicate the patient is having an adverse response to the medication. It is essential for the nurse to monitor the patient closely for any signs of allergic reactions, including hives, as they can quickly progress to more severe reactions such as anaphylaxis. Other adverse effects listed in the choices, such as blurred vision, tinnitus, and vomiting, are not typically associated with an acute allergic reaction to Penicillin.
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The nurse is teaching a patient about taking aspirin. Which are important points to include? (Select all that apply.)
- A. Advise the patient to avoid alcohol while taking aspirin.
- B. Instruct the patient to take aspirin before meals on an empty stomach.
- C. Instruct the patient to inform the dentist of the aspirin dosage before having dental work.
- D. Instruct the patient to inform the surgeon of the aspirin dosage before having surgery.
Correct Answer: D
Rationale: Aspirin is an antiplatelet agent that can increase the risk of bleeding, especially when combined with alcohol or during invasive procedures like dental work or surgery. Patients should avoid alcohol to reduce the risk of gastrointestinal bleeding. Additionally, informing healthcare providers about aspirin use is crucial to prevent excessive bleeding during procedures. Taking aspirin on an empty stomach is not recommended, as it can increase the risk of gastric irritation. Therefore, the correct teaching points are to avoid alcohol, inform the dentist, and inform the surgeon about aspirin use.
The nurse is caring for a young patient with a closed head injury who has an intracranial pressure of 35 (normal <20) and serum osmolality of 330 mOsm/kg. The nurse would anticipate which action?
- A. Administration of mannitol
- B. Withholding mannitol at this time, but taking other measures to reduce intracranial pressure
- C. Administration of sodium nitroprusside
- D. Taking no action at this time because the patient has a serum osmolality of 330, which will offset the effects of the elevated intracranial pressure
Correct Answer: B
Rationale: Mannitol is an osmotic diuretic used to reduce intracranial pressure (ICP) by drawing fluid out of the brain tissue. However, it should be used cautiously in patients with elevated serum osmolality, as it can exacerbate hyperosmolality and lead to renal failure or other complications. In this case, the patient's serum osmolality is already high (330 mOsm/kg), so mannitol should be withheld, and other measures to reduce ICP, such as elevating the head of the bed, maintaining proper oxygenation, and avoiding hypercapnia, should be prioritized. Sodium nitroprusside (C) is used for hypertension, not ICP, and taking no action (D) is inappropriate given the elevated ICP.
Barbiturates are contraindicated in a dental patient with: II. emphysema III. Undiagnosed severe pain III. hypertension IV. Acute intermittent porphyria
- A. I, III & IV
- B. I & IV only
- C. II & III only
- D. II only
Correct Answer: A
Rationale: Barbiturates are central nervous system depressants that can exacerbate conditions such as emphysema, hypertension, and acute intermittent porphyria.
When a patient is experiencing digoxin toxicity, which clinical situation would necessitate the use
- A. ? (Select all that apply.)
- B. The patient reports seeing colorful halos around lights.
- C. The patient™s serum potassium level is above 5 mEq/L.
- D. The patient is experiencing nausea and anorexi
Correct Answer: D
Rationale: When a patient is experiencing digoxin toxicity, severe sinus bradycardia that does not respond to cardiac pacing is a clinical situation that would necessitate the use of digoxin-specific antibody fragments (Digibind). This intervention is required to counteract the toxic effects of digoxin on the heart, especially in cases of severe bradycardia that can compromise cardiac output and lead to serious consequences. In this scenario, Digibind works by binding to digoxin molecules, thereby neutralizing their effects and helping to restore normal cardiac function.
Basis for pharmacotherapeutics
- A. Selective action of drugs with regard to diagnosis, preventive and treatment of disease
- B. Bioavailability of drugs
- C. Biologic half-life of drugs
- D. Renal clearance and elimination of drugs
Correct Answer: A
Rationale: The basis for pharmacotherapeutics lies in the selective action of drugs with regard to the diagnosis, prevention, and treatment of diseases. Pharmacotherapeutics involves the use of drugs to manage diseases and improve health outcomes. Drugs are carefully selected based on their mechanism of action, efficacy, safety profile, and suitability for a specific condition. The goal is to achieve optimal therapeutic effects while minimizing potential adverse effects. By understanding the selective action of drugs in targeting specific pathways or processes in the body, healthcare providers can customize treatment regimens to individual patients and achieve the best possible outcomes.