Which of the following agents exerts its therapeutic effect in multiple sclerosis via potassium channel blockade?
- A. Dalfampridine
- B. Donepezil
- C. Riluzole
- D. Bromocriptine
Correct Answer: A
Rationale: Dalfampridine treats MS by blocking potassium channels in demyelinated axons, enhancing nerve conduction and improving walking ability. Exposed potassium channels in MS leak current, impairing signal propagation; dalfampridine's blockade restores function. Donepezil boosts acetylcholine for Alzheimer's. Riluzole reduces glutamate in ALS. Bromocriptine, a dopamine agonist, manages Parkinson's. Dalfampridine's unique potassium channel action directly addresses MS's neurological deficit, supported by clinical evidence, making it the correct agent here.
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Which of the following 'overdoses' is most commonly associated with respiratory alkalosis, but when more severe a metabolic acidosis?
- A. Methanol
- B. Lead
- C. Paracetamol
- D. Salicylate
Correct Answer: D
Rationale: Overdose toxicities differ in acid-base effects. Methanol causes metabolic acidosis via formic acid, not respiratory alkalosis. Lead poisoning leads to anemia or neurologic issues, rarely acid-base shifts. Paracetamol overdose induces lactic acidosis from liver failure, not respiratory changes initially. Salicylate (e.g., aspirin) overdose stimulates the respiratory center early, causing hyperventilation and respiratory alkalosis (low pCO2), but severe cases add metabolic acidosis (high anion gap) from uncoupled oxidative phosphorylation and lactic acid buildup. Codeine, an opioid, depresses respiration, causing acidosis, not alkalosis. Salicylate's dual pattern is distinctive, requiring urgent recognition—initial alkalosis shifts to acidosis as toxicity worsens, guiding bicarbonate or dialysis treatment.
An adolescent client will receive Depo-Provera as a method of birth control. She asks the nurse how long the drug will be effective. What is the best response by the nurse?
- A. 2 months
- B. 6 months
- C. 1 year
- D. 3 months
Correct Answer: D
Rationale: Depo-Provera, a progestin injection, provides contraception by inhibiting ovulation for 3 months , requiring re-administration every 12 weeks. This duration is based on its pharmacokinetic profile, ensuring reliable hormone levels. Two months underestimates, risking unprotected gaps. Six months or 1 year overestimate, reducing efficacy mid-cycle. The nurse's accurate response (D) educates the client on timing, ensuring adherence and preventing unintended pregnancy, aligning with clinical standards for injectable contraceptives.
A patient with extremely high blood pressure (BP) is in the emergency department. The physician will order therapy with nitroglycerin to manage the patient™s BP. Which form of nitroglycerin is most appropriate?
- A. Sublingual spray
- B. Transdermal patch
- C. Oral capsule
- D. IV infusion
Correct Answer: D
Rationale: In the emergency management of a patient with extremely high blood pressure, intravenous (IV) administration of nitroglycerin is the most appropriate form of delivery. IV infusion provides rapid and precise control of blood pressure by allowing the medication to take effect quickly and be titrated to the desired blood pressure level. This route of administration is crucial in acute settings like the emergency department, where immediate blood pressure management is needed. Other forms of nitroglycerin, such as sublingual spray, transdermal patch, or oral capsule, may not provide the rapid onset of action required in this critical situation.
What is a side effect of Heparin?
- A. nausea
- B. diarrhea
- C. bleeding
- D. bronchospasms
Correct Answer: C
Rationale: A common side effect of Heparin, which is an anticoagulant medication, is the risk of bleeding. Heparin works by preventing the formation of blood clots, which can lead to a bleeding risk as it inhibits the normal clotting process. Patients taking Heparin should be monitored closely for signs of bleeding, such as easy bruising, prolonged bleeding from minor cuts, or blood in the urine or stools. It is important for healthcare providers to closely monitor patients on Heparin therapy and adjust the dosage as needed to minimize the risk of excessive bleeding.
A nurse is providing administration instruction to the wife of a client going home on intermittent enteral nutrition. Which information should the nurse include?
- A. Clean the equipment between each feeding administration
- B. Once mixed, enteral feeding should hang no more than 8 hours
- C. Refrigerate any feeding that is not needed for a feeding
- D. Keep the area around the insertion site clean
Correct Answer: A
Rationale: Cleaning equipment between each enteral feeding is vital to prevent bacterial contamination, as residual formula can foster microbial growth, risking infections like gastroenteritis in a client already nutritionally compromised. While limiting hang time is important, evidence suggests a 4-hour maximum, not 8, to minimize spoilage-though this isn't the focus here. Refrigerating unused feeding preserves its integrity, preventing degradation or bacterial proliferation, which is critical for safety. Keeping the insertion site clean reduces infection risk at the tube entry, a common complication in enteral therapy. Cleaning equipment stands out as a proactive step the wife can take between feedings, directly impacting hygiene and client safety, whereas other points address storage or site care, which, while essential, are secondary to the immediate post-feeding action of equipment maintenance in this context.
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