Nokea
The physician tells the nurse, 'The medication I’m prescribing for the client enhances the GABA system.' Evaluation will be facilitated if the nurse correctly interprets this statement to mean the medication is expected to:
- A. Increase alertness
- B. Decrease anxiety
- C. Reduce hallucinations
- D. Produce mood elevation
Correct Answer: B
Rationale: The correct answer is B: Decrease anxiety. GABA is an inhibitory neurotransmitter that helps regulate anxiety and stress. Enhancing the GABA system means increasing its activity, which would result in a calming effect, reducing anxiety. A: Increasing alertness is unlikely because GABA is associated with relaxation, not alertness. C: GABA's role is not primarily in reducing hallucinations. D: While GABA may indirectly influence mood, its primary role is in anxiety regulation.
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Which of the following antipsychotic agents is used in combination with an opioid drug fentanyl in neuroleptanalgesia?
- A. Haloperidol
- B. Droperidol
- C. Chlorpromazine
- D. Clozapine
Correct Answer: B
Rationale: The correct answer is B: Droperidol. Droperidol is commonly used in combination with fentanyl in neuroleptanalgesia due to its potent antiemetic and sedative properties. It helps enhance the analgesic effects of fentanyl and provides better sedation during procedures.
Rationale:
1. Haloperidol (A) is not typically used in neuroleptanalgesia as it lacks the same synergistic effects with opioids as droperidol.
2. Chlorpromazine (C) is not commonly used in neuroleptanalgesia and is more often used in the treatment of psychotic disorders.
3. Clozapine (D) is an atypical antipsychotic and is not part of the standard neuroleptanalgesia regimen.
In summary, droperidol is the preferred antipsychotic agent for use in combination with fentanyl in neuroleptanalgesia due to its specific pharmacological properties that
Regarding the mechanism of action of hormones indicate the FALSE statement:
- A. Hormones interact with the specific receptors in the wall of the cells
- B. Cyclic AMP acts as a second messenger system
- C. They stimulate adenylcyclase enzyme
- D. Many hormones owe their effect to primary actions on subcellular membrane.
Correct Answer: D
Rationale: The correct answer is D because many hormones actually exert their effects by interacting with specific receptors on the cell membrane rather than acting directly on subcellular membranes. This interaction triggers a series of intracellular events that lead to a cellular response. Option A is true as hormones indeed interact with specific receptors on cell walls. Option B is true as cyclic AMP is a common second messenger system utilized by hormones. Option C is true as many hormones stimulate adenylcyclase enzyme as part of their signaling pathway.
Which of the following mediators is found mainly in long descending pathways from the midbrain to the dorsal horn?
- A. Prostaglandin E
- B. Dynorphin
- C. Enkephalin
- D. Glutamate
Correct Answer: B
Rationale: The correct answer is B: Dynorphin. Dynorphin is mainly found in long descending pathways from the midbrain to the dorsal horn. It acts as an endogenous opioid peptide that modulates pain perception. Prostaglandin E, Enkephalin, and Glutamate are not primarily found in these pathways. Prostaglandin E is involved in inflammation and fever, Enkephalin acts as an endogenous opioid peptide in pain modulation, and Glutamate is a major excitatory neurotransmitter in the central nervous system. Thus, B is the correct choice based on its specific localization in the described pathways.
Which competitive neuromuscular blocking agent could be used in patients with renal failure?
- A. Atracurium
- B. Succinylcholine
- C. Pipecuronium
- D. Doxacurium
Correct Answer: A
Rationale: The correct answer is A: Atracurium. Atracurium is preferred in patients with renal failure because it is metabolized by Hoffman elimination independent of renal or hepatic function. Succinylcholine (B) is not recommended in renal failure due to prolonged paralysis. Pipecuronium (C) and Doxacurium (D) are primarily eliminated by renal excretion, making them unsuitable for patients with renal failure.
Choose the drug which has a direct effect on platelet membrane to inhibit aggregation, release reaction and to improve platelet survival in extra-corporeal circulation
- A. Dipyridamole
- B. Ticlopidine
- C. Aspirin
- D. Sulfinpyrazone
Correct Answer: B
Rationale: Ticlopidine acts directly on the platelet membrane by inhibiting ADP-induced aggregation and release reactions, and it improves platelet survival in extracorporeal circulation, unlike the other options which have different primary mechanisms.