The risk for physical and psychological dependence is high from which class of medications, which is rarely used to treat insomnia or anxiety?
- A. Barbiturates.
- B. Nonsteroidal anti-inflammatory drugs (NSAIDs).
- C. Benzodiazepines.
- D. Selective serotonin reuptake inhibitors (SSRIs).
- G. A
Correct Answer: Barbiturates have high dependence risk and are rarely used for insomnia/anxiety due to safer alternatives like benzodiazepines. NSAIDs, benzodiazepines, and SSRIs don't fit this profile.
Rationale: The correct answer is A: Barbiturates. Barbiturates are known to have a high risk of physical and psychological dependence due to their sedative effects. They are rarely used to treat insomnia or anxiety nowadays because safer alternatives like benzodiazepines are available. Nonsteroidal anti-inflammatory drugs (NSAIDs) are primarily used for pain and inflammation, not for insomnia or anxiety. Benzodiazepines are commonly prescribed for these conditions but have a lower risk of dependence compared to barbiturates. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants and are not typically used for the treatment of insomnia or anxiety. Therefore, the correct answer is A because barbiturates have a high dependence risk and are not commonly used for these conditions.
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The healthcare provider has ordered 1000 mL of 0.9% sodium chloride to be administered intravenously over 5 hours. The drop factor on the tubing is 15 drops/mL. How many milliliters per hour and how many drops per minute will you administer?
- A. 200 mL/hr and 45 drops/min
- B. 250 mL/hr and 45 drops/min
- C. 250 mL/hr and 50 drops/min
- D. 200 mL/hr and 50 drops/min
- G. D
Correct Answer: 1000 mL ÷ 5 hr = 200 mL/hr. 200 mL/hr ÷ 60 min = 3.33 mL/min × 15 drops/mL = 49.95 drops/min, rounded to 50. Thus, 200 mL/hr and 50 drops/min.
Rationale: The correct answer is D: 200 mL/hr and 50 drops/min. To calculate the mL per hour, you divide the total mL by the total hours (1000 mL ÷ 5 hr = 200 mL/hr). To find the mL per minute, you divide the mL per hour by 60 minutes (200 mL/hr ÷ 60 min = 3.33 mL/min). Next, to determine the drops per minute, you multiply the mL per minute by the drop factor (3.33 mL/min × 15 drops/mL = 49.95 drops/min, rounded to 50 drops/min). Therefore, the correct administration rate is 200 mL/hr and 50 drops/min.
Choices A, B, and C are incorrect because they do not align with the correct calculation based on the given parameters. Choice A and B have incorrect mL per hour values, and Choice C has an incorrect drops per minute value.
What is the priority action for a nurse caring for a client with a urinary tract infection before administering prescribed antibiotics?
- A. Obtain a blood pressure
- B. Obtain a urine specimen for culture and sensitivity
- C. Obtain a PTT
- D. Obtain a platelet count .
- G. B
Correct Answer: Blood pressure is routine, not priority. Urine culture identifies the bacteria and antibiotic sensitivity before treatment. PTT and platelet counts are unrelated to UTI antibiotics.
Rationale: The correct answer is B: Obtain a urine specimen for culture and sensitivity. This is the priority action because it helps identify the specific bacteria causing the UTI and determines the most effective antibiotic for treatment. This step is crucial for appropriate antibiotic therapy and to prevent antibiotic resistance. A: Obtaining a blood pressure is a routine assessment and not directly related to UTI treatment. C and D: Obtaining a PTT and platelet count are not necessary for assessing or treating a UTI; these tests are unrelated to UTI management. Therefore, the priority action for a nurse caring for a client with a UTI is to obtain a urine specimen for culture and sensitivity.
When beginning herbal products, the nurse understands that the best way to identify allergic or other adverse reactions is to have the client:
- A. Take less than the recommended dose initially.
- B. Never take with prescription medications.
- C. Check with a reputable pharmacist.
- D. Use only one herbal preparation at a time.
- G. D
Correct Answer: Lower doses may not reveal reactions. Avoiding prescriptions isn't always necessary. Pharmacist consultation is good but not best for identification. One product at a time isolates reactions.
Rationale: The correct answer is D: Use only one herbal preparation at a time. By using only one herbal preparation at a time, the nurse can accurately identify any allergic or adverse reactions that may occur. This approach allows for clear isolation of the effects of each herb, making it easier to pinpoint the source of any reactions. Taking lower doses (choice A) may not always reveal reactions as some individuals may still have adverse effects. Never taking herbal products with prescription medications (choice B) is overly restrictive and not always necessary. Checking with a reputable pharmacist (choice C) is a good practice for general information but may not be the most effective way to identify specific reactions.
How does drug therapy of tuberculosis differ from that of most other infections?
- A. Patients with tuberculosis have no symptoms.
- B. Antituberculosis drugs are used extensively for treating active disease, not prevention.
- C. Patients usually require therapy for a shorter period.
- D. Mycobacteria have a cell wall that is resistant to penetration by anti-infective drugs.
- G. D
Correct Answer: TB patients can have symptoms. Drugs treat both active disease and prevention (latent TB). TB therapy is longer (6-9 months+). Mycobacteria's resistant cell wall necessitates prolonged, combined drug therapy.
Rationale: The correct answer is G. The rationale is as follows:
1. TB patients can have symptoms: TB can present with symptoms such as cough, fever, weight loss, and night sweats.
2. Drugs treat both active disease and prevention: Antituberculosis drugs are used for both treating active TB disease and preventing latent TB from developing into active disease.
3. TB therapy is longer: TB therapy typically lasts 6-9 months or longer due to the slow-growing nature of Mycobacterium tuberculosis and the need to prevent drug resistance.
4. Mycobacteria's resistant cell wall: Mycobacteria have a unique cell wall that is resistant to penetration by many antibiotics, necessitating prolonged and combined drug therapy for effective treatment.
In summary, the other choices are incorrect because patients with TB can have symptoms, antituberculosis drugs are used for both treatment and prevention, therapy duration is usually longer, and the unique cell wall of Mycobacteria requires specific drug regimens.
Which of the following is a violation of safe practice when administering insulin?
- A. Administering ordered insulin subcutaneously.
- B. Using an insulin syringe to administer the insulin dose.
- C. Drawing up the ordered dose in a 3 mL syringe.
- D. Verifying the drawn-up insulin dose with another nurse.
- G. C
Correct Answer: Subcutaneous administration and insulin syringes are correct. A 3 mL syringe lacks insulin unit markings, risking errors. Verification with another nurse is a safety practice.
Rationale: The correct answer is C: Drawing up the ordered dose in a 3 mL syringe is a violation of safe practice when administering insulin. Here's a detailed rationale:
1. Administering ordered insulin subcutaneously (Choice A) is correct as insulin is typically administered subcutaneously.
2. Using an insulin syringe to administer the insulin dose (Choice B) is correct, as insulin syringes are specifically designed for accurate insulin dosing.
3. Drawing up the ordered dose in a 3 mL syringe (Choice C) is incorrect because 3 mL syringes lack insulin unit markings, increasing the risk of dosing errors.
4. Verifying the drawn-up insulin dose with another nurse (Choice D) is a safety practice and is correct to ensure accuracy and prevent errors.
In summary, choice C is incorrect because using a 3 mL syringe can lead to dosing errors, while the other choices are safe practices in administering insulin.
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