Nokea
Which of the following antibiotics is contraindicated in patients with myasthenia gravis?
- A. Vancomycin
- B. Gentamicin
- C. Daptomycin
- D. Cephalexin
Correct Answer: B
Rationale: Gentamicin, an aminoglycoside, worsens neuromuscular blockade in myasthenia gravis, making it contraindicated.
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The first-line treatment for cough related to an upper respiratory tract infection (URI) in a 5-year-old child is:
- A. Fluids and symptomatic care
- B. Dextromethorphan and guaifenesin syrup (Robitussin DM for Kids)
- C. Guaifenesin and codeine syrup (Tussin AC)
- D. Chlorpheniramine and dextromethorphan syrup (Nyquil for Kids)
Correct Answer: A
Rationale: Fluids and symptomatic care are safest and recommended for URI cough in young children; cough suppressants are discouraged under 6.
Which of the following is a biguanides which is used for the treatment of diabetes mellitus type II:
- A. Repaglinide
- B. Glibenclamide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin is the primary biguanide used for type 2 diabetes, reducing hepatic glucose production and improving insulin sensitivity.
A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following statements should the nurse give?
- A. Be sure to limit your potassium intake while taking the medication.
- B. You should check your blood pressure every 8 hours while taking this medication.
- C. Your medication dosage will be increased if you develop tachycardia.
- D. Change positions slowly when you move from sitting to standing.
Correct Answer: D
Rationale: Antihypertensives can cause orthostatic hypotension; changing positions slowly prevents dizziness or falls.
The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred?
- A. Hyperventilation
- B. Elevated blood pressure
- C. Local pain at the burn site
- D. Local rash at the burn site
Correct Answer: A
Rationale: Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be expected from the pain that occurs with a burn injury.
The nurse is teaching a patient about rifampin. Which statement by the patient indicates understanding of the teaching?
- A. I should not wear soft contact lenses while taking rifampin
- B. I will need regular eye examinations while taking this drug
- C. I will report orange urine to my provider immediately
- D. I understand that renal toxicity is a common adverse effect
Correct Answer: A
Rationale: Rifampin stains fluids red-orange, risking soft lens damage; eye exams are for ethambutol, and urine color is benign. Patients taking rifampin should be warned that urine, feces, saliva, sputum, sweat, and tears may turn a harmless red-orange color.