Nokea
When recommending dimenhydrinate (Dramamine) to treat motion sickness, patients should be instructed to:
- A. Take the dimenhydrinate after they get nauseated
- B. Drink lots of water while taking the dimenhydrinate
- C. Take the dimenhydrinate 15 minutes before it is needed
- D. Double the dose if one tablet is not effective
Correct Answer: C
Rationale: Dimenhydrinate is most effective taken 15-30 minutes before motion to prevent nausea; post-nausea , hydration , or doubling are less optimal.
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Smokers are at risk for vitamin C deficiency. It is recommended that smokers take vitamin C supplement.
- A. 100 mg/day
- B. 500 mg/day
- C. 1,000 mg/day
- D. 35 mg/day more than nonsmokers
Correct Answer: D
Rationale: Smokers require an additional 35 mg/day of vitamin C due to increased oxidative stress.
All of the following are adverse effects of phenothiazines except
- A. Rigidity and tremor
- B. Menstrual irregularities
- C. Cholestatic jaundice
- D. Systolic hypertension
Correct Answer: D
Rationale: Phenothiazines cause hypotension, not hypertension.
A nurse is caring for a client who is admitted to undergo a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic?
- A. Peptic ulcer disease
- B. Breast cancer
- C. Diabetes mellitus
- D. Schizophrenia
Correct Answer: D
Rationale: Ketamine can exacerbate schizophrenia due to its psychomimetic effects.
Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?
- A. A 35-year-old woman with cervical cancer
- B. A 41-year-old man with kidney stones
- C. A 50-year-old man with cirrhosis of the liver
- D. A 62-year-old woman in acute renal failure
Correct Answer: C
Rationale: The liver is the most important site of drug metabolism. If the liver is not functioning effectively, as in patients with cirrhosis, drugs will not metabolize normally so that toxic levels could develop unless dosage is reduced. A patient with cervical cancer or kidney stones would not be expected to have altered ability to metabolize drugs so long as no liver damage existed. The patient with renal failure would have altered excretion of the drugs through the renal system but metabolism would not be impacted.
The reason that two MMR vaccines at least a month apart are recommended is:
- A. The second dose of MMR 'boosts' the immunity built from the first dose
- B. Two vaccines 1 month apart is the standard dosing for all live virus vaccines
- C. If the two MMR vaccine doses are given too close together there is a greater likelihood of severe localized reaction to the vaccine
- D. Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR
Correct Answer: D
Rationale: Two MMR doses ensure 99% immunity, as 95% respond to one dose; boosting is secondary to this goal.