Nokea
What is pica?
- A. dependency on alcohol
- B. increased iron in the diet
- C. the sickle cell trait
- D. eating ice
Correct Answer: D
Rationale: Pica represents the ingestion of nonfood substances that leads to a clinical iron deficiency and might actually be the first sign of a problem. Clients eat a wide range of nonfood items, including ice, clay, dirt, and paste.
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The new nurse describes the action of TCAs as relieving symptoms of depression by inhibiting neuronal uptake of the neurotransmitters serotonin and norepinephrine. Place an X on the labeled site where the new nurse is stating that inhibition takes place.
- A. Axon of the presynaptic neuron
- B. Rceptor site
- C. Inactivator
- D. Neurotransmitor
- E. Mitochondrion
Correct Answer: B
Rationale: Neuronal uptake of neurotransmitters occurs at the receptor sites on the postsynaptic neuron. [Image-based question; X placed on postsynaptic receptor sites.]
Which of the following medications is a serotonin antagonist that might be used to relieve nausea and vomiting?
- A. metoclopramide (Reglan)
- B. onedansetron (Zofran)
- C. hydroxyzine (Vistaril)
- D. prochlorperazine (Compazine)
Correct Answer: B
Rationale: Zofran is a serotonin antagonist that can be used to relieve nausea and vomiting. The other medications can be used for nausea and vomiting, but they have different mechanisms of action.
The client taking carbamazepine XR for seizure control reports that pieces of the medication are being passed into the stool. Which action by the nurse is most important?
- A. Report this to the health care provider.
- B. Reassure the client that this is normal.
- C. Collect the stool for laboratory analysis.
- D. Document the findings in the medical record.
Correct Answer: B
Rationale: A: It is inappropriate to report an expected finding to the HCP. B: Carbamazepine XR (Tegretol XR) is a sustained-release medication with a coating that is not absorbed but is excreted in feces and may be visible in stool. The nurse should reassure the client that this is normal. C: Collecting the stool for laboratory analysis is not necessary because the coating is not absorbed but excreted in the stool. D: The nurse should document the client teaching but usually would not document the presence of the coating in the client's stool.
The client calls a clinic 2 weeks after taking oral carbidopa-levodopa, stating that the medication has been ineffective in controlling the symptoms of PD. What nursing action is most important?
- A. Review how to correctly take the carbidopa-levodopa.
- B. Contact the HCP to address a change in the dose.
- C. Reinforce that it may take 1 to 2 months to see effects.
- D. Reinforce eating a diet high in protein and vitamin B6.
Correct Answer: C
Rationale: A: Reviewing the method for taking carbidopa-levodopa, including foods to avoid, may be important, but option C is most important. More information is needed to determine whether the client is taking it correctly. B: A dosage change is unnecessary because it has been only two weeks since the client started carbidopa-levodopa. C: With oral administration of carbidopa-levodopa (Sinemet), it usually takes 1 to 2 months before an effect is noted, although in some cases it may require up to 6 months. D: A high-protein diet can slow or prevent absorption of carbidopa-levodopa. Vitamin B6 increases the action of decarboxylases that destroy levodopa in the body's periphery, reducing the effects of carbidopa-levodopa. Foods high in pyridoxine should be avoided.
Which of these medications has the least risk of causing tinnitus?
- A. Aspirin
- B. Lasix
- C. Gentamicin
- D. Fluoxetine
Correct Answer: D
Rationale: Gentamicin, Lasix, and Aspirin are all ototoxic drugs that have a potential side effect of causing tinnitus, a ringing in the ear. Fluoxetine, an SSRI, is not typically associated with tinnitus.