Nokea
Which medication ordered for a patient with a substance abuse history has the greatest risk for abuse?
- A. Lomotil
- B. Diazepam
- C. Phenobarbital
- D. Lortab
Correct Answer: D
Rationale: Lortab is a Schedule III drug with a higher potential for abuse than Lomotil (Schedule V), Diazepam (Schedule IV), and Phenobarbital (Schedule IV).
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AH of the following do not cross the blood brain barrier except
- A. Pyridostigmine
- B. Neostigmine
- C. Physostigmine
- D. Ambenonium
Correct Answer: C
Rationale: Physostigmine, a tertiary amine, crosses the blood-brain barrier; others (quaternary amines) do not.
A nurse in an acute care facility is caring for a client who is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?
- A. Intestinal ileus
- B. Neutropenia
- C. Deurium
- D. Hyperthermia
Correct Answer: C
Rationale: Nitroprusside can cause delirium (C, likely typo for delirium), a CNS side effect in toxicity.
The telephone triage nurse receives a call from a patient asking for a prescription for a narcotic to manage his surgical pain. The nurse explains that narcotic prescriptions must be written and cannot be called in to the pharmacy. The patient says, Why are narcotics so difficult to get a prescription for? What is the nurse's best response?
- A. The Drug Enforcement Agency (DEA) determines the risk for addiction and the Food and Drug Administration (FDA) enforces their control.
- B. The increase in the number of drug addicts has made the rules stronger.
- C. The Centers for Disease Control and Prevention (CDC) regulates use of controlled substances to reduce the risk of injury.
- D. Controlled substances like narcotics are controlled by the FDA and the DEA.
Correct Answer: D
Rationale: Controlled substances are controlled by the FDA and the DEA: the DEA enforces control while the FDA determines abuse potential. Regulations related to controlled substances have remained strict and specific and have not been significantly impacted by substance abusers. The CDC is not involved in control of narcotics and other controlled substances.
NSAIDs increase the risk of CNS adverse effects when taken with which group of antibiotics?
- A. Macrolides
- B. Penicillins
- C. Aminoglycosides
- D. Quinolones
Correct Answer: D
Rationale: Quinolones (e.g., ciprofloxacin) with NSAIDs can increase CNS effects like seizures due to GABA inhibition.
A nurse is caring for a client who has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?
- A. Bruising
- B. Fever
- C. Abdominal pain
- D. Rash
Correct Answer: B
Rationale: Fever is a key sign of serotonin syndrome, a potentially life-threatening condition from SSRI overdose.