Nokea
The principal central nervous system effect of the opioid analgesics with affinity for a mu receptor is:
- A. Analgesia
- B. Respiratory depression
- C. Euphoria
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Opioid analgesics with affinity for the mu receptor exert their principal central nervous system effects through various mechanisms.
1. Analgesia: Opioids bind to mu receptors, inhibiting pain transmission in the CNS.
2. Respiratory depression: Stimulation of mu receptors in the brainstem suppresses the respiratory drive.
3. Euphoria: Activation of mu receptors in the limbic system can induce feelings of euphoria.
Therefore, all these effects are collectively produced by opioids with mu receptor affinity. Other choices are incorrect because they do not encompass the comprehensive range of central nervous system effects associated with this class of analgesics.
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A patient has been taking naltrexone (ReVia) as part of the treatment for addiction to heroin. The nurse expects that the naltrexone will have which therapeutic effect for this patient?
- A. Naltrexone prevents the cravings for opioid drugs.
- B. Naltrexone works as a safer substitute for the heroin until the patient completes withdrawal.
- C. The patient will experience flushing, sweating, and severe nausea if he takes heroin while on naltrexone.
- D. If opioid drugs are used while taking naltrexone, euphoria is not produced; thus, the opioid’s desired effects are lost.
Correct Answer: D
Rationale: The correct answer is D because naltrexone is an opioid antagonist that blocks the euphoric effects of opioids. Here's the rationale:
1. Naltrexone blocks opioid receptors, preventing the euphoria associated with opioid use.
2. By blocking the euphoric effects, naltrexone reduces the reinforcing properties of opioids.
3. This decreases the likelihood of relapse as the patient does not experience the desired effects of opioids.
4. Choices A, B, and C are incorrect because naltrexone does not prevent cravings, act as a substitute, or cause adverse reactions like flushing and sweating.
What does the nurse know to be correct concerning the use of mannitol in patients?
- A. It decreases intracranial pressure.
- B. It increases intraocular pressure.
- C. It causes sodium and potassium retention.
- D. It causes diuresis in several days.
Correct Answer: A
Rationale: The correct answer is A: It decreases intracranial pressure. Mannitol is an osmotic diuretic that works by drawing water from brain tissue into the bloodstream, reducing intracranial pressure. This helps to manage conditions such as cerebral edema. Choices B and C are incorrect because mannitol does not impact intraocular pressure or cause sodium and potassium retention. Choice D is incorrect as mannitol causes diuresis rapidly within minutes to hours, not over several days.
The client asks about side effects of taking digoxin. How does the nurse respond?
- A. Anorexia can be a side effect of digoxin.
- B. Tachycardia can be a side effect of digoxin.
- C. Constipation can be a side effect of digoxin.
- D. Urinary retention can be a side effect of digoxin.
Correct Answer: A
Rationale: Anorexia, nausea, and vomiting are common early signs of digoxin toxicity due to its gastrointestinal effects; tachycardia is not typical as digoxin slows the heart rate.
Which of the following hypnotic drugs is used intravenously as anesthesia?
- A. Thiopental
- B. Phenobarbital
- C. Flurazepam
- D. Zolpidem
Correct Answer: A
Rationale: The correct answer is A: Thiopental. Thiopental is used intravenously as anesthesia due to its rapid onset and short duration of action, making it suitable for induction of anesthesia. Phenobarbital, Flurazepam, and Zolpidem are not typically used for anesthesia due to slower onset, longer duration, and different mechanisms of action. Thiopental's pharmacokinetic profile and effectiveness in inducing anesthesia make it the most appropriate choice among the options provided.
Which of the following instructions regarding lithium therapy should be included in a nurse’s discharge teaching? (Select the one tha does not apply.)
- A. Avoid excessive use of beverages containing caffeine.
- B. Maintain a consistent sodium intake.
- C. Consume at least 2,500 to 3,000 mL of fluid per day.
- D. Restrict sodium content.
Correct Answer: D
Rationale: The correct answer is D because lithium therapy requires a consistent sodium intake to maintain proper electrolyte balance. Restricting sodium content can lead to lithium toxicity. Choice A is important to avoid interactions with caffeine. Choice B is crucial to prevent fluctuations in sodium levels. Choice C is essential to prevent dehydration and maintain proper kidney function. Therefore, restricting sodium content is not a suitable instruction for lithium therapy.