Nokea
Which cephalosporin generation is effective against methicillin-resistant Staphylococcus aureus (MRSA)?
- A. First generation
- B. Second generation
- C. Third generation
- D. Fifth generation
Correct Answer: D
Rationale: Fifth-generation cephalosporins, like ceftaroline, are effective against MRSA, unlike earlier generations.
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Jake, a 45-year-old patient with schizophrenia, was recently hospitalized for acute psychosis due to medication noncompliance. He was treated with IM long-acting haloperidol. Besides monitoring his schizophrenia symptoms, the patient should be assessed by his primary care provider:
- A. For excessive weight loss
- B. With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS)
- C. Monthly for tolerance to the haloperidol
- D. Only by the mental health provider, as most NPs in primary care do not care for mentally ill patients
Correct Answer: B
Rationale: Haloperidol can cause EPS, monitored using the AIMS.
The following drug is not secreted in bile
- A. Penicillin
- B. Phenolphthalein
- C. Novobiocin
- D. Erythromycin
Correct Answer: A
Rationale: Penicillin is excreted via kidneys; others are secreted in bile.
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.
A patient arrives in the emergency department in an acute state of alcohol intoxication and reports chronic consumption of several six packs of beer every day for the past year. The nurse anticipates administering which medication or treatment?
- A. Chlordiazepoxide (Librium)
- B. Disulfiram (Antabuse)
- C. Gastric lavage
- D. Vasoconstrictors
Correct Answer: A
Rationale: Chlordiazepoxide prevents alcohol withdrawal symptoms; disulfiram is post-detox. To prevent acute withdrawal and delirium tremens, a long-acting benzodiazepine, such as chlordiazepoxide, is given.
A contraindication for topical corticosteroid usage in a male with atopic dermatitis (eczema) is:
- A. Parasite infection
- B. Viral infection
- C. Bacterial infection
- D. Spirochete infection
Correct Answer: B
Rationale: Topical corticosteroids worsen viral infections (e.g., herpes) due to immunosuppression.