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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Anti-inflammatory action of glucocorticoids is determined by:
- A. Inhibition of phospholipase A2
- B. Activation of phospholipase A2
- C. Inhibition of cyclooxygenase type-1
- D. Inhibition of cyclooxygenase type-2
Correct Answer: A
Rationale: Glucocorticoids inhibit phospholipase A2, reducing the production of inflammatory mediators like prostaglandins.
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.
A 26-year-old lady with primary infertility presents with hot flashes, nausea and a palpable adnexal mass.
- A. Clomiphene
- B. Hydrochlorothiazide
- C. Furosemide
- D. Mifepristone
Correct Answer: A
Rationale: Clomiphene induces ovulation, with side effects including hot flashes and ovarian cysts.
Bismuth subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints. Bismuth subsalicylate:
- A. May lead to toxicity if taken with aspirin
- B. Is contraindicated in children with flu-like illness
- C. Has antimicrobial effects against bacterial and viral enteropathogens
- D. All of the above
Correct Answer: D
Rationale: All apply: bismuth with aspirin risks salicylate toxicity , is contraindicated in kids with flu (B, Reye's syndrome), and has antimicrobial action .
A nurse in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?
- A. Calcium 9.2 mg/dL
- B. Calcium 10.3 mg/dL
- C. Potassium 3.4 mEq/L
- D. Potassium 4.8 mEq/
Correct Answer: C
Rationale: Hypokalemia (3.4 mEq/L, C) increases digoxin toxicity risk by enhancing its effects.