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What is the correct statement concerning noncompetitive antagonism:
- A. The potency of the drug does not change
- B. the number of receptors able to bind the agonist is affected
- C. by increasing the conc. of the agonist, we cannot overcome the problem
- D. non of the above is wrong
Correct Answer: D
Rationale: All statements are correct: noncompetitive antagonism reduces efficacy (not potency), affects receptor availability, and cannot be overcome by increasing agonist concentration.
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Antiemitic used to prevent aspiration in emergency surgery
- A. Ondansetrone
- B. Promethazine
- C. Metoclopromide
- D. Ranitidine
Correct Answer: B
Rationale: Promethazine (antihistamine) prevents aspiration with sedative effects.
Potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propylthiouracil. Patients should be taught to report:
- A. Tinnitus and decreased salivation
- B. Fever and sore throat
- C. Hypocalcemia and osteoporosis
- D. Laryngeal edema and difficulty swallowing
Correct Answer: B
Rationale: Fever and sore throat signal granulocytopenia with propylthiouracil; other symptoms are unrelated.
The patient looks at the prescription provided by the doctor and asks the nurse whether he can request a generic substitution. The nurse answers No when noting what on the prescription?
- A. No refills
- B. DAW
- C. Brand name used on prescription
- D. Patient older than 65 years of age
Correct Answer: B
Rationale: DAW stands for dispense as written and means that the doctor does not want a generic substituted for the prescribed medication. Requesting no refills does not preclude the substitution of a generic medication. Even when the brand name is ordered, the pharmacist can substitute a generic equivalent so long as the prescriber does not write DAW. Generic substitutions are not impacted by the patients age.
Which medication order requires nursing judgment and means administer if needed?
- A. Morphine 4 mg IV stat
- B. Morphine 4 mg IV prior to procedure
- C. Morphine 4 mg IV four times a day
- D. Morphine 4 mg IV every 4 hours PRN
Correct Answer: D
Rationale: PRN indicates for the nurse to administer morphine every 4 hours if needed and requires nursing judgment. Stat means the dose of morphine would be given immediately, not as needed. The orders for the dose of morphine to be given prior to the patient's scheduled procedure and four times a day, do not indicate to give the dose as needed.
Medication agreements or 'Pain Medication Contracts' are recommended to be used:
- A. Universally for all prescribing for chronic pain
- B. For patients who have repeated requests for pain medication
- C. When you suspect a patient is exhibiting drug-seeking behavior
- D. For patients with pain associated with malignancy
Correct Answer: A
Rationale: Pain contracts are recommended universally for chronic pain to set expectations, not just for repeated requests , suspicion , or cancer .