Nokea
The nurse is counseling a patient who wants to stop smoking. Which statement by the nurse is correct?
- A. Bupropion (Zyban) is effective and does not have serious adverse effects
- B. Nicotine replacement therapies are effective and eliminate the need for behavioral therapy
- C. Varenicline (Chantix) may be used short-term for 1 to 2 months
- D. You may experience headaches and increased appetite for several months after stopping smoking
Correct Answer: D
Rationale: Headaches and appetite increase are common nicotine withdrawal symptoms; bupropion has side effects, and varenicline is longer-term. Headaches and increased appetite are common during nicotine withdrawal and may last for several months.
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Jim is having a hip replacement surgery and would like to self-donate blood for the surgery. In addition to being prescribed epogen alpha he should also be prescribed:
- A. Folic acid to prevent megaloblastic anemia
- B. Iron, to start when the epogen starts
- C. An antihypertensive to counter the adverse effects of epogen
- D. Vitamin B12 to prevent pernicious anemia
Correct Answer: B
Rationale: Iron supports erythropoiesis with epoetin alfa; antihypertensives manage side effects, not prophylaxis.
When melatonin is used to induce sleep, the recommendation is that the patient:
- A. Take 10 mg 30 minutes before bed nightly
- B. Take 1 to 5 mg 30 minutes before bed nightly
- C. Not take melatonin more than three nights a week
- D. Combine melatonin with zolpidem (Ambien) for the greatest impact on sleep
Correct Answer: B
Rationale: 1-5 mg of melatonin 30 minutes before bed is the recommended dose for sleep induction.
Tick the second messenger of G-protein-coupled (metabotropic) receptor:
- A. Adenylyl cyclase
- B. Sodium ions
- C. Phospholipase C
- D. cAMP
Correct Answer: D
Rationale: cAMP is a classic second messenger generated by G-protein-coupled receptors via adenylyl cyclase.
Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?
- A. Betamethasone, an inhaled corticosteroid
- B. Salmeterol, an inhaled long-acting beta-agonist
- C. Albuterol, a short-acting beta-agonist
- D. Montelukast, a leukotriene modifier
Correct Answer: B
Rationale: Salmeterol carries a Black Box Warning for increased asthma-related deaths, especially in African Americans, requiring caution; others are safer.
Despite good blood pressure control, an NP might change a patient's drug from an angiotensin-converting enzyme (ACE) inhibitor to an angiotensin II receptor blocker (ARB) because the ARB:
- A. Is stronger than the ACE inhibitor
- B. Does not produce a dry, hacky cough
- C. Has no effect on the renal system
- D. Reduces sodium and water retention
Correct Answer: B
Rationale: ARBs lack the cough side effect common with ACE inhibitors.