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When prescribing temazepam (Restoril) for insomnia, patient education includes:
- A. Take temazepam nightly approximately 15 minutes before bedtime.
- B. Temazepam should not be used more than three times a week for less than 3 months.
- C. Drinking 1 ounce of alcohol will cause additive effects and the patient will sleep better.
- D. Exercise for at least 30 minutes within 2 hours of bedtime to enhance the effects of temazepam.
Correct Answer: B
Rationale: Temazepam is recommended short-term (e.g., ≤3 times/week) to avoid dependence.
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A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy Category B drug. What would the nurse inform the patient?
- A. Adequate studies in pregnant women have demonstrated there is no risk to the fetus.
- B. Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women.
- C. Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant women.
- D. There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks.
Correct Answer: B
Rationale: Category B indicates that animal studies have not demonstrated a risk to the fetus. However, there have not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of pregnancy and no evidence of risk in later trimesters. Category A indicates that adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters. Category C indicates that animal studies have shown an adverse effect on the fetus, but no adequate studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the use of the drugs in pregnant women may outweigh potential risks.
The client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed?
- A. Weight loss
- B. Relief of heartburn
- C. Reduction of steatorrhea
- D. Absence of abdominal pain
Correct Answer: C
Rationale: Pancrelipase (Pancrease MT) is a pancreatic enzyme used in clients with pancreatitis as a digestive aid. The medication should reduce the amount of fatty stools (steatorrhea). Another intended effect could be improved nutritional status. It is not used to treat abdominal pain or heartburn. Its use could result in weight gain but should not result in weight loss if it is aiding in digestion.
Please select a correct statement:
- A. Steroids excreted in maximal amount in evening and night time - between 20-24 h
- B. Steroids maximal excretion is in morning time - between -4-8 h
- C. Steroids maximal secretion is in daytime- between -12-16 h
- D. Steroids decrease sensitivity of vessels and bronchus towards catecholamines
Correct Answer: B
Rationale: Steroids peak in the morning (4-8 AM) due to circadian rhythm of cortisol secretion.
When given subcutaneously, how long until neutral protamine Hagedorn insulin begins to take effect (onset of action) after administration?
- A. 15 to 30 minutes
- B. 60 to 90 minutes
- C. 3 to 4 hours
- D. 6 to 8 hours
Correct Answer: B
Rationale: NPH insulin has an onset of 60-90 minutes; shorter is rapid-acting, longer is basal.
It is customary to administer systemic corticosteroids early in the morning because:
- A. This prevents early morning bronchospasms
- B. To inhibit adrenocorticotrophic hormone over secretion
- C. To achieve high plasma concentrations throughout the day
- D. To prevent adrenocortex suppression
Correct Answer: D
Rationale: Morning dosing aligns with cortisol peaks, minimizing adrenal suppression.