Nokea
Which of the following antipsychotic agents is preferable in patients with coronary and cerebrovascular disease?
- A. Chlorpromazine
- B. Fluphenazine
- C. Haloperidol
- D. Perphenazine
Correct Answer: C
Rationale: The correct answer is C: Haloperidol. Haloperidol is preferable in patients with coronary and cerebrovascular disease due to its lower risk of causing cardiovascular adverse effects compared to the other options. Chlorpromazine (A) can cause orthostatic hypotension and prolong QT interval. Fluphenazine (B) can lead to QT prolongation and hypotension. Perphenazine (D) also carries a risk of QT prolongation and orthostatic hypotension. In contrast, Haloperidol has a more favorable cardiovascular safety profile, making it the preferred choice for patients with coronary and cerebrovascular disease.
You may also like to solve these questions
Which of the following alfa receptor antagonists is useful in reversing the intense local vasoconstriction caused by inadvertent infiltration of norepinephrine into subcutaneous tissue during intravenous administration?
- A. Propranolol
- B. Phentolamine
- C. Tamsulosin
- D. Ergotamine
Correct Answer: B
Rationale: The correct answer is B: Phentolamine. Phentolamine is an alpha receptor antagonist that can rapidly reverse the vasoconstriction caused by local infiltration of norepinephrine. It works by blocking alpha receptors, leading to vasodilation and improved blood flow in the affected area. Propranolol (A) is a beta-blocker and not effective in reversing alpha receptor-mediated vasoconstriction. Tamsulosin (C) is an alpha-1 blocker primarily used for benign prostatic hyperplasia, not for acute vasoconstriction reversal. Ergotamine (D) is a vasoconstrictor used in treating migraines, which would exacerbate the problem in this scenario.
A 46-year-old man underwent surgery to remove a glioma of the left brain lobe. An intravenous infusion of a drug was started to induce controlled hypotension to minimize blood loss during surgery. Which of the following drugs would be most appropriate for this purpose?
- A. Labetalol
- B. Hydralazine
- C. Nifedipine
- D. Nitroprusside
Correct Answer: D
Rationale: The correct answer is D: Nitroprusside. Nitroprusside is a potent vasodilator that can rapidly induce controlled hypotension by relaxing smooth muscle in blood vessels. This helps in minimizing blood loss during surgery. Labetalol (A) is a non-selective beta-blocker with alpha-blocking activity, which may not provide rapid hypotension. Hydralazine (B) is a direct vasodilator that can cause reflex tachycardia and may not be as effective in controlled hypotension. Nifedipine (C) is a calcium channel blocker primarily used for hypertension but does not provide rapid hypotension like nitroprusside.
Barbiturates are being replaced by hypnotic benzodiazepines because of:
- A. Low therapeutic index
- B. Suppression in REM sleep
- C. High potential of physical dependence and abuse
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Barbiturates have a low therapeutic index, leading to a narrow range between therapeutic and toxic doses. They suppress REM sleep, which can lead to negative effects on sleep quality. Barbiturates also have a high potential for physical dependence and abuse, making them less desirable compared to benzodiazepines. Therefore, all the given reasons collectively contribute to the shift towards using hypnotic benzodiazepines over barbiturates.
A client who has been taking buspirone (BuSpar) as prescribed for 2 days is close to discharge. Which statement indicates to the nurse that the client has an understanding of important discharge teaching?
- A. “I cannot drink any alcohol with this medication.”
- B. “It is going to take 2 to 3 weeks in order for me to begin to feel better.”
- C. “This drug causes physical dependence and I need to strictly follow doctor’s orders.”
- D. “I can’t take this medication with food. It needs to be taken on an empty stomach.”
Correct Answer: B
Rationale: Step 1: Buspirone (BuSpar) is an anxiolytic medication that typically takes 2 to 3 weeks for the full therapeutic effect to be experienced.
Step 2: Client understanding of this delayed onset of action is crucial for managing expectations and adherence.
Step 3: Choice B indicates the client understands the timeframe for symptom improvement.
Step 4: Other choices are incorrect: A is not specific to buspirone, C is incorrect as buspirone is not associated with physical dependence, and D is inaccurate as buspirone can be taken with or without food.
Step 5: Therefore, choice B is the correct answer as it reflects an understanding of the medication's timeline for effectiveness.
The client has developed neutropenia from a medication. What medication might this be?
- A. Metoprolol
- B. Captopril
- C. Lisinopril
- D. Guanfecine
Correct Answer: B
Rationale: Captopril, an ACE inhibitor, is associated with rare neutropenia, unlike the other listed drugs.