Nokea
Which of the following drugs is used for the management of atropine intoxication?
- A. Physostigmine
- B. Neostigmine
- C. Endrophonium
- D. Donepezil
Correct Answer: A
Rationale: Physostigmine, a cholinesterase inhibitor, crosses the BBB to reverse atropine's central effects.
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Henry is 82 years old and takes two aspirin every morning to treat the arthritis pain in his back. He states the aspirin helps him to 'get going' each day. Lately he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry?
- A. Add an H2 blocker such as ranitidine to his therapy
- B. Discontinue the aspirin and switch him to Vicodin for the pain
- C. Decrease the aspirin dose to one tablet daily
- D. Have Henry take an antacid 15 minutes before taking the aspirin each day
Correct Answer: A
Rationale: An H2 blocker reduces aspirin-induced heartburn; stopping or antacids don't address chronic use.
A number of barriers and concerns exist before the goals of a safe and efficient information technology (IT) system can be realized. Which of the following is NOT a barrier to adoption and use of IT in prescribing drugs?
- A. Cost of initial setup
- B. Access to highly skilled experts
- C. Compatibility between systems
- D. Patient confidentiality risks
Correct Answer: B
Rationale: Access to skilled experts facilitates, rather than hinders, IT adoption.
Martin is a 60-year-old patient with hypertension. The first-line decongestant to prescribe would be:
- A. Oral pseudoephedrine
- B. Oral phenylephrine
- C. Nasal oxymetazoline
- D. Nasal azelastine
Correct Answer: C
Rationale: Nasal oxymetazoline , a topical decongestant, has less systemic effect on blood pressure than oral options ; azelastine is an antihistamine.
A nurse is preparing a drug for administration to a patient. The drug does not have an indicated use for the patient's medical diagnosis. What should the nurse do?
- A. Administer the drug as ordered.
- B. Question the prescriber concerning the ordered drug.
- C. Ask a coworker his or her thoughts about the ordered drug for the patient.
- D. Ask the patient why the drug has been prescribed for him or her.
Correct Answer: B
Rationale: If the nurse is not sure about giving a drug, the order should be questioned. The nurse should never give a medication that is not clear. Mistakes do happen and the drug ordered, if not approved for the condition that the patient has, could be an error on someone's part. The person who wrote the order should be questioned, not a co worker, who probably does not know why an off-label drug is being used. It would be unprofessional and inappropriate to ask the patient about the drug.
A patient is being seen in the clinic for rheumatoid arthritis. Which of the following statements would indicate that she may be developing a complication from her rheumatoid medication, chloroquine (Aralen)?
- A. I have to urinate all the time.'
- B. Sometimes I have blurred vision.'
- C. I have tingling and numbness in my arms and legs.'
- D. Sometimes I feel like I am losing my balance when I walk.'
Correct Answer: B
Rationale: Chloroquine (Aralen) can cause ocular toxicity with blurring of vision, color vision changes, corneal damage, and blindness. Increased urination and tingling and numbness are signs of hyperkalemia and hypokalemia. Loss of balance can be caused by auditory damage due to drug toxicity.