Nokea
Which of the following antiparkinsonian drugs may cause vasospasm?
- A. Amantadine
- B. Bromocriptine
- C. Carbidopa
- D. Entacapone
Correct Answer: B
Rationale: Bromocriptine, a dopamine D2 agonist used in Parkinson's, has ergot alkaloid properties, which can cause vasospasm by stimulating vascular smooth muscle receptors, occasionally leading to Raynaud's-like symptoms or digital ischemia. Amantadine, an NMDA antagonist, enhances dopamine release but lacks vasoconstrictive effects. Carbidopa inhibits dopa decarboxylase, aiding levodopa delivery without vascular impact. Entacapone, a COMT inhibitor, extends levodopa's duration but doesn't affect vessels. Ropinirole, a non-ergot agonist, avoids vasospasm. Bromocriptine's ergot-derived vasoconstriction, though rare, distinguishes it among antiparkinsonian drugs, requiring caution in patients with vascular risks.
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Samuel, a 65-year-old patient comes into the hospital for an anginal attack. Which of the following is an important nursing intervention when administering Nitroglycerine?
- A. If the patient has more pain, apply another transdermal patch and keep the others on
- B. Don't wash the skin after removing a transdermal patch
- C. Remove the transdermal patch 10-12 hours every night to prevent tolerance
- D. Monitor blood pressure only after administration
Correct Answer: C
Rationale: The correct nursing intervention when administering Nitroglycerine to a patient like Samuel is to remove the transdermal patch 10-12 hours every night to prevent tolerance. Tolerance can develop rapidly with Nitroglycerine, leading to decreased effectiveness in managing anginal attacks. By removing the patch at night, the body has a chance to "reset" and reduce the likelihood of tolerance development. This practice helps maintain the drug's effectiveness and ensures better symptom control for the patient.
A client is prescribed with carbamazepine (Tegretol) for the treatment of bipolar disorder. Which of the following laboratory results indicates that the client is experiencing a side effect of this medication?
- A. Neutrophil count of 1,200/mm3.
- B. Platelet count of 160,000/mm3.
- C. Uric acid level of 4mg/dl.
- D. SGPT (ALT) level 50 units per liter of serum.
Correct Answer: A
Rationale: Carbamazepine can cause leukopenia, including neutropenia, as a side effect. A neutrophil count of 1,200/mm3 is below the normal range and indicates a potential adverse effect. Platelet count, uric acid, and SGPT levels are within normal ranges and do not indicate side effects. Therefore, the neutrophil count is the concerning result.
A patient in the clinic reports difficulty tolerating the current ACE inhibitor medication, and questions if another medication could be used. The nurse correctly suspects the prescriber will choose which medication, which affects the renin-angiotensin-aldosterone system?
- A. atenolol
- B. losartan
- C. spironolactone
- D. adenosine
Correct Answer: B
Rationale: Losartan is an angiotensin II receptor blocker (ARB) that affects the renin-angiotensin-aldosterone system (RAAS) and is often used as an alternative to ACE inhibitors. Atenolol (A) is a beta-blocker, spironolactone (C) is a potassium-sparing diuretic, and adenosine (D) is used for arrhythmias. ARBs like losartan are preferred for patients who cannot tolerate ACE inhibitors due to side effects like cough or angioedema.
A healthcare professional is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion. Which of the following results indicates that the heparin infusion should be increased?
- A. aPTT of 90 seconds
- B. Platelet count of 150,000/mm³
- C. INR of 1.0
- D. Hgb of 15 g/dL
Correct Answer: A
Rationale: An aPTT of 90 seconds is above the therapeutic range for heparin, which typically falls between 60-80 seconds. This indicates that the current heparin dose is too high, and the infusion rate should be decreased to avoid excessive anticoagulation and the risk of bleeding. Monitoring aPTT is crucial in adjusting heparin therapy to maintain it within the therapeutic range.
What is a severe adverse effect of iron supplementation?
- A. Seizures
- B. Dry mouth
- C. Edema
- D. Serotonin syndrome
Correct Answer: A
Rationale: A severe adverse effect of iron supplementation is seizures. Iron toxicity can lead to symptoms such as abdominal pain, vomiting, bloody diarrhea, lethargy, and in severe cases, seizures. It is important for individuals taking iron supplements to follow recommended dosages to prevent adverse effects.