This drug is a respiratory stimulant:
- A. Doxapram
- B. Promethazine
- C. Dornase α
- D. Oxygen
Correct Answer: A
Rationale: Doxapram stimulates breathing by acting on the respiratory center in the brainstem.
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A patient is being seen in the clinic for rheumatoid arthritis. Which of the following statements would indicate that she may be developing a complication from her rheumatoid medication, chloroquine (Aralen)?
- A. I have to urinate all the time.'
- B. Sometimes I have blurred vision.'
- C. I have tingling and numbness in my arms and legs.'
- D. Sometimes I feel like I am losing my balance when I walk.'
Correct Answer: B
Rationale: Chloroquine (Aralen) can cause ocular toxicity with blurring of vision, color vision changes, corneal damage, and blindness. Increased urination and tingling and numbness are signs of hyperkalemia and hypokalemia. Loss of balance can be caused by auditory damage due to drug toxicity.
Henry is 82 years old and takes two aspirin every morning to treat the arthritis pain in his back. He states the aspirin helps him to 'get going' each day. Lately he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry?
- A. Add an H2 blocker such as ranitidine to his therapy
- B. Discontinue the aspirin and switch him to Vicodin for the pain
- C. Decrease the aspirin dose to one tablet daily
- D. Have Henry take an antacid 15 minutes before taking the aspirin each day
Correct Answer: A
Rationale: An H2 blocker reduces aspirin-induced heartburn; stopping or antacids don't address chronic use.
An example of a first-dose reaction that may occur includes:
- A. Orthostatic hypotension that does not occur with repeated doses
- B. Purple glove syndrome with phenytoin use
- C. Hemolytic anemia from ceftriaxone use
- D. Contact dermatitis from neomycin use
Correct Answer: C
Rationale: Hemolytic anemia from ceftriaxone can occur after the first dose as a Type II reaction, unlike orthostatic hypotension (A, adaptive) or others (B, D, later onset).
A nurse is preparing a drug for administration to a patient. The drug does not have an indicated use for the patient's medical diagnosis. What should the nurse do?
- A. Administer the drug as ordered.
- B. Question the prescriber concerning the ordered drug.
- C. Ask a coworker his or her thoughts about the ordered drug for the patient.
- D. Ask the patient why the drug has been prescribed for him or her.
Correct Answer: B
Rationale: If the nurse is not sure about giving a drug, the order should be questioned. The nurse should never give a medication that is not clear. Mistakes do happen and the drug ordered, if not approved for the condition that the patient has, could be an error on someone's part. The person who wrote the order should be questioned, not a co worker, who probably does not know why an off-label drug is being used. It would be unprofessional and inappropriate to ask the patient about the drug.
A nurse is providing instructions to a client who has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?
- A. Take the albuterol at the same time each day.
- B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
- C. Use beclomethasone if experiencing an acute episode.
- D. Avoid shaking the beclomethasone before us
Correct Answer: B
Rationale: Albuterol (bronchodilator) should be used before beclomethasone (steroid) to open airways for better steroid delivery.
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