When educating a client with a new prescription for Omeprazole to manage GERD, which of the following information should the nurse include?
- A. Take the medication before meals.
- B. You may need to take this medication for a long time.
- C. Increase your intake of vitamin C while taking this medication.
- D. Expect immediate relief of symptoms.
Correct Answer: A
Rationale: The correct answer is to take the medication before meals. Omeprazole should be taken before meals to ensure its effectiveness in reducing stomach acid production. This timing allows the medication to work on reducing acid secretion when the stomach is most actively producing it, leading to better control of symptoms. Choice B is incorrect because not all patients with GERD need to take Omeprazole for the rest of their lives; the duration of treatment varies. Choice C is incorrect as there is no specific recommendation to increase vitamin C intake while taking Omeprazole. Choice D is incorrect because Omeprazole may take a few days to start providing symptom relief, so immediate relief should not be expected.
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To which pharmacologic classification does the drug propranolol belong?
- A. Beta Blockers
- B. Cholinergics
- C. Immune globulins
- D. Barbiturates
Correct Answer: A
Rationale: Propranolol belongs to the pharmacologic classification of Beta Blockers. Beta blockers work by blocking the action of adrenaline and other stress hormones on beta-adrenergic receptors. They are commonly used to manage conditions like high blood pressure, angina, and arrhythmias. Choice B, Cholinergics, is incorrect because cholinergics work by stimulating the parasympathetic nervous system, unlike beta blockers that block adrenergic receptors. Choice C, Immune globulins, is incorrect as it refers to antibodies used to boost the immune system, not the mechanism of action of propranolol. Choice D, Barbiturates, is incorrect as barbiturates are a different class of drugs that act as central nervous system depressants, primarily used as sedatives and anesthetics.
A client is starting a new prescription for enalapril. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Rise slowly from a sitting position.
- C. Avoid salt substitutes.
- D. Avoid exposure to sunlight.
Correct Answer: C
Rationale: The correct instruction for a client starting enalapril is to avoid salt substitutes. Salt substitutes may contain potassium, which could lead to elevated potassium levels when combined with enalapril, increasing the risk of hyperkalemia. Choices A, B, and D are incorrect because there is no specific need to take enalapril with food, rise slowly from a sitting position, or avoid exposure to sunlight when taking this medication.
A client is prescribed levothyroxine for hypothyroidism. Which of the following findings should indicate to the nurse that the medication is effective?
- A. Decreased heart rate
- B. Increased energy levels
- C. Weight loss
- D. Improved mental clarity
Correct Answer: B
Rationale: Increased energy levels are a key indicator of the effectiveness of levothyroxine in treating hypothyroidism. Levothyroxine works to regulate thyroid hormone levels, which can lead to improved energy levels as the body's metabolism is restored. While the other options may also improve with treatment, increased energy levels directly reflect the correction of the thyroid hormone imbalance. Decreased heart rate can be an indicator of overmedication, weight loss can be attributed to increased metabolism but may not directly reflect the effectiveness of levothyroxine, and improved mental clarity is a more general cognitive improvement that may not directly relate to thyroid function.
A client is undergoing preparation for extensive colorectal surgery. Which of the following oral antibiotics should be administered to suppress normal flora in the GI tract?
- A. Kanamycin
- B. Gentamicin
- C. Neomycin
- D. Tobramycin
Correct Answer: C
Rationale: The correct answer is C: Neomycin. Neomycin, an aminoglycoside antibiotic, is administered orally before GI surgery to eliminate the normal flora in the large intestine. This helps reduce the risk of postoperative infections by decreasing the bacterial load in the gut. Choices A, B, and D (Kanamycin, Gentamicin, Tobramycin) are not typically used to suppress normal flora in the GI tract before colorectal surgery.
Recent studies into the pathogenesis of halothane-induced malignant hyperthermia indicate which of the following as the likely implicating cause?
- A. Drug toxicity
- B. Excitation-contraction coupling defect
- C. Myoplasmic sodium defect
- D. Oxygen-hemoglobin concentration deficit
Correct Answer: B
Rationale: Malignant hyperthermia (MH) from halothane involves excitation-contraction coupling defects . MH, a genetic disorder, stems from ryanodine receptor (RYR1) mutations, causing uncontrolled calcium release in muscle, not drug toxicity . Sodium defects , oxygen deficits , or neural overmodulation (E) aren't implicated. This coupling defect triggers hypermetabolism, explaining MH's rapid onset with halothane exposure.