Nokea
Which of the following medications would you administer for an overdose of acetaminophen?
- A. Naloxone
- B. Vitamin K
- C. Acetylcysteine
- D. Atropine
Correct Answer: C
Rationale: Acetylcysteine is the antidote for an acetaminophen overdose. Acetaminophen overdose can cause liver damage due to its toxic metabolite buildup in the liver. Acetylcysteine works by replenishing glutathione, which helps in detoxifying the toxic metabolite of acetaminophen. Administering acetylcysteine within 8-10 hours of the overdose is crucial in preventing severe liver damage and improving the patient's outcome. Naloxone is used for opioid overdose, Vitamin K for treating specific types of bleeding disorders, and Atropine for drug poisoning or certain types of poisoning, but they are not indicated for an acetaminophen overdose.
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A child was brought to the emergency room complaining of right upper quadrant abdominal pain, nausea, and vomiting. Upon the interview of the nurse to the mother, the client has been taking a long-
- A. Which of the following medications should be readily available?
- B. naltrexone (ReVi
- C. urea (Ureaphil)
- D. acetylcysteine (Mucomyst)
Correct Answer: A
Rationale: The presentation of right upper quadrant abdominal pain, nausea, and vomiting in a child with a history of taking a long-acting formulation of valproic acid (Depakene) is concerning for valproic acid overdose. Valproic acid toxicity can lead to liver damage, which may present with symptoms such as abdominal pain, nausea, and vomiting. In cases of valproic acid overdose, acetylcysteine (Mucomyst) is commonly used as a treatment to help prevent or reduce liver damage by replenishing glutathione stores and acting as a reactive oxygen species scavenger. Therefore, acetylcysteine should be readily available in this scenario to initiate prompt treatment and potentially prevent severe liver injury.
An injection of penicillin into a penicillin-sensitized person may lead to death due to:
- A. absence of histamine
- B. a Shwartzman's reaction
- C. release of enzymes from polymorphonuclear leukocytes
- D. constriction of bronchioli and drop in blood pressure
Correct Answer: B
Rationale: A Shwartzman's reaction is a severe inflammatory response that occurs when a person who has previously been sensitized to penicillin is re-exposed to the drug. This exaggerated response can lead to widespread activation of inflammatory mediators and is characterized by endotoxin-induced intravascular coagulation. This can result in a cascade of events leading to tissue damage, organ failure, and potentially death. It is different from a typical allergic reaction mediated by histamine release or constriction of bronchioli and drop in blood pressure. Additionally, the release of enzymes from polymorphonuclear leukocytes is not directly related to the fatal outcome of a penicillin injection in a sensitized individual.
This is the basis for calculation of infant dose in Clark's Rule :
- A. age ;
- B. weight ;
- C. height ;
- D. surface area ;
Correct Answer: B
Rationale: In Clark's Rule, the basis for calculating the infant dose is weight. This is because weight is a crucial factor in determining the appropriate dosage for infants. Adjusting the dose based on weight helps in ensuring that the medication is administered safely and effectively. Infants have different proportions of body weight compared to older children and adults, which can influence how medications are metabolized in their bodies. Therefore, using weight as the basis for dosage calculation in Clark's Rule helps in providing a more accurate and individualized dose for infants.
Heparin is classified under what class?
- A. Laxative
- B. ACE inhibitor
- C. Anti-convulsant
- D. Antithrombotic
Correct Answer: D
Rationale: Heparin is classified as an antithrombotic agent. It is a medication that helps prevent blood clot formation by inhibiting the activity of certain clotting factors in the blood. Heparin is commonly used in the treatment and prevention of conditions such as deep vein thrombosis, pulmonary embolism, and during certain medical procedures to prevent clot formation. It is not classified as a laxative, ACE inhibitor, or anti-convulsant based on its mechanism of action and therapeutic use.
Which drug concentration is appropriate to administer in an order for epinephrine 0.3 mg IM to treat a severe allergic reaction in an adult patient?
- A. 1:10,000
- B. 0.736111111
- C. 0.111111111
- D. 1:10
Correct Answer: B
Rationale: The appropriate concentration for epinephrine 0.3 mg IM in an adult for a severe allergic reaction is 1:1000. This concentration is used for intramuscular administration, while 1:10,000 (A) is used for intravenous administration in cardiac arrest. Concentrations of 1:100 (C) and 1:10 (D) are not standard for this purpose.