Nokea
Which class of drugs is successful in treating an ulcer caused by H. pylori?
- A. Antacids
- B. H2-receptor blockers
- C. Antibiotics
- D. Proton-pump inhibitors
- G. C
Correct Answer: Antacids relieve symptoms. H2 blockers and PPIs reduce acid but don't kill H. pylori. Antibiotics eradicate the bacteria, treating the ulcer's cause.
Rationale: The correct answer is C: Antibiotics. Antacids (choice A) only provide symptomatic relief by neutralizing stomach acid. H2-receptor blockers (choice B) and proton-pump inhibitors (choice D) are used to reduce stomach acid secretion but do not directly target H. pylori bacteria. Choice C, antibiotics, are successful in treating ulcers caused by H. pylori because they specifically target and eradicate the bacteria, addressing the root cause of the ulcer. Therefore, antibiotics are the most effective class of drugs for treating H. pylori-induced ulcers.
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The nurse is caring for a patient who is experiencing anaphylaxis. The family asks the nurse why the patient is having difficulty breathing. The nurse responds based on what knowledge?
- A. Bronchoconstriction in response to the allergen.
- B. Compensation for a rapid fall in blood pressure.
- C. Reflex tachycardia.
- D. Seizures are likely to occur.
- G. A
Correct Answer: Bronchoconstriction from allergens causes breathing difficulty in anaphylaxis. Hypotension, tachycardia, and seizures are secondary or unrelated.
Rationale: The correct answer is A: Bronchoconstriction in response to the allergen. During anaphylaxis, the body releases histamine causing bronchoconstriction, leading to difficulty breathing. This is a direct response to the allergen and can lead to respiratory distress. Choice B, compensation for a rapid fall in blood pressure, is incorrect as hypotension is a secondary effect of anaphylaxis. Choice C, reflex tachycardia, is also incorrect as tachycardia is a compensatory response to hypotension, not the cause of difficulty breathing. Choice D, seizures are likely to occur, is incorrect as seizures are not a common manifestation of anaphylaxis. Therefore, the correct answer is A as it directly relates to the pathophysiology of anaphylaxis.
A patient is allergic to penicillin. Which class of antibiotics might they also have a cross-allergy to?
- A. Cephalosporins
- B. Sulfonamides
- C. Macrolides
- D. Aminoglycosides
- G. A
Correct Answer: Cephalosporins share a similar structure with penicillin, risking cross-allergy. Sulfonamides, macrolides, and aminoglycosides lack this relation.
Rationale: The correct answer is A: Cephalosporins. Cephalosporins have a beta-lactam ring structure similar to penicillin, leading to potential cross-allergy. Sulfonamides, macrolides, and aminoglycosides have different chemical structures, reducing the likelihood of cross-allergy. Therefore, individuals allergic to penicillin may have a cross-allergy to cephalosporins due to structural similarity, making it the correct choice.
The patient with tuberculosis is now on isoniazid (INH). Which laboratory test should the nurse monitor?
- A. BUN
- B. PT and PTT
- C. Liver enzymes (LFTs)
- D. CBC
- G. C
Correct Answer: BUN, PT/PTT, and CBC aren't specific to INH. Liver enzymes are monitored due to INH's hepatotoxicity risk.
Rationale: The correct answer is C. The nurse should monitor liver enzymes (LFTs) in a patient on isoniazid (INH) due to the risk of hepatotoxicity associated with this medication. 1. Isoniazid is known to cause liver damage in some patients. 2. Monitoring liver enzymes can help detect any liver dysfunction early. 3. LFTs include tests such as ALT, AST, and bilirubin, which can indicate liver damage. 4. Regular monitoring of LFTs is essential to ensure the safe use of INH. Incorrect choices: A. BUN is not specific to INH. B. PT and PTT are not directly related to INH use. D. CBC is not specifically required for monitoring INH therapy.
A nurse is assisting with the care of four clients who have peptic ulcer disease. The nurse should identify that misoprostol (Cytotec) is contraindicated for which of the following clients?
- A. A client who is pregnant.
- B. A client who has osteoarthritis.
- C. A client who has a urinary tract infection.
- D. A client who has a kidney stone.
- G. A
Correct Answer: Misoprostol can induce labor or miscarriage, making it contraindicated in pregnancy. It's safe for osteoarthritis, UTIs, and kidney stones as it doesn't interact adversely with these conditions.
Rationale: Correct Answer: A. A client who is pregnant.
Rationale: Misoprostol is contraindicated in pregnancy as it can induce labor or miscarriage due to its uterotonic effects. This medication is used to prevent gastric ulcers in patients taking NSAIDs, not for conditions like osteoarthritis, urinary tract infection, or kidney stones. Thus, it is important to avoid its use in pregnant individuals to prevent harm to the fetus.
Summary of Other Choices:
B: Misoprostol is safe for a client with osteoarthritis as it does not pose any specific risks or contraindications for this condition.
C: Misoprostol does not interact adversely with urinary tract infections, so it is safe for a client with this condition.
D: Misoprostol does not have any contraindications for kidney stones; therefore, it is safe for a client with this condition.
According to an evidence-based approach, what is the most productive way to treat anxiety disorders?
- A. Provide the client with a powerful medication.
- B. Uncover and address the cause of anxiety.
- C. Allow the client to self-medicate with OTC medications.
- D. Immediately start multiple-drug therapy.
- G. B
Correct Answer: Medication alone isn't most productive. Cognitive behavioral therapy addressing anxiety causes is evidence-based. Self-medication and multiple drugs initially are not recommended.
Rationale: The correct answer is B: Uncover and address the cause of anxiety. An evidence-based approach for treating anxiety disorders involves cognitive behavioral therapy (CBT) to address the underlying causes of anxiety. By identifying and working through the root causes of anxiety, clients can develop coping strategies and long-term solutions. Providing powerful medications (A) may only offer temporary relief and not address the underlying issues. Allowing self-medication with OTC medications (C) can be dangerous and lead to misuse. Immediately starting multiple-drug therapy (D) can increase the risk of side effects and interactions without addressing the root cause of anxiety. Thus, focusing on uncovering and addressing the causes of anxiety through CBT is the most productive and evidence-based approach.