Nokea
Which one of the following antipsychotics has been shown to be a partial agonist at the dopamine D2 receptor?
- A. Aripiprazole
- B. Clozapine
- C. Haloperidol
- D. Risperidone
Correct Answer: A
Rationale: Aripiprazole, a third-generation antipsychotic, acts as a partial agonist at D2 receptors, stabilizing dopamine activity: it activates receptors in low-dopamine states (e.g., negative symptoms) and competes with excess dopamine (e.g., psychosis), reducing side effects like EPS. Clozapine, a second-generation drug, has weak D2 affinity, targeting 5HT2 and other receptors. Haloperidol, a first-generation antipsychotic, is a D2 antagonist. Risperidone and thioridazine block D2 fully, not partially. Aripiprazole's unique partial agonism, confirmed by pharmacological data, balances efficacy and tolerability, distinguishing it in schizophrenia treatment.
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A client has been prescribed a new oral hypoglycemic agent for diabetes. Which of the following statements by the client indicates a need for further teaching?
- A. I will take this medication with my evening snack.
- B. I will monitor my blood sugar levels before each meal.
- C. I will take this medication as soon as I wake up.
- D. I will follow my exercise plan as usual.
Correct Answer: A
Rationale: Taking an oral hypoglycemic agent with an evening snack may lead to hypoglycemia during the night. It is important to follow the prescribed timing for medication administration to maintain blood sugar levels within the target range. The medication is usually taken before meals to help control postprandial blood glucose levels effectively. Choice B is correct as monitoring blood sugar levels before each meal is a good practice. Choice C is incorrect as taking the medication upon waking up may align with certain oral hypoglycemic agents' dosing schedules. Choice D is also correct as regular exercise is an important part of managing diabetes.
A client has a new prescription for Atenolol. Which of the following statements should be included by the healthcare provider?
- A. Take the medication with a high-fat meal.
- B. Monitor your heart rate before taking the medication.
- C. Expect a persistent cough.
- D. Avoid foods high in fiber.
Correct Answer: B
Rationale: When a client is prescribed Atenolol, a beta-blocker, they should monitor their heart rate before taking the medication. It is crucial because if the heart rate is below 60 bpm, the client needs to contact their healthcare provider for further guidance and evaluation. Choices A, C, and D are incorrect. Atenolol does not need to be taken with a high-fat meal, does not typically cause a persistent cough, and there is no need to avoid foods high in fiber when taking this medication.
Phenobarbital (luminal) is given to a client for a short treatment of anxiety. Which of the following results would indicate a therapeutic serum range of the medication?
- A. 5-10 mcg/ml
- B. 15-40 mcg/ml
- C. 45-65 mcg/ml
- D. 50-90 mcg/ml
Correct Answer: A
Rationale: The therapeutic serum range for phenobarbital (luminal) in the treatment of anxiety is typically 5-10 mcg/ml. This range is considered effective in managing anxiety symptoms while minimizing the risk of side effects associated with higher levels of the medication. Lower serum levels may be ineffective in treating anxiety, while higher levels increase the risk of adverse effects. Therefore, maintaining the serum concentration within the range of 5-10 mcg/ml is optimal for therapeutic benefits with minimal risks.
A healthcare professional is obtaining a medication history from a client who is to receive Imipenem-cilastatin IV to treat an infection. Which of the following medications the client also receives puts them at risk for a medication interaction?
- A. Regular insulin
- B. Furosemide
- C. Valproic acid
- D. Ferrous sulfate
Correct Answer: C
Rationale: The correct answer is C, Valproic acid. Imipenem-cilastatin decreases the blood levels of valproic acid, an antiseizure medication, which can lead to increased seizure activity. Monitoring and adjusting the dosage of valproic acid may be necessary when co-administered with Imipenem-cilastatin to prevent adverse effects. Choices A, B, and D do not typically interact significantly with Imipenem-cilastatin and are not associated with a high risk of adverse interactions in this scenario.
A client has a new prescription for Sucralfate. Which of the following instructions should the nurse include?
- A. Take the medication on an empty stomach.
- B. Increase your intake of high-sodium foods.
- C. Take the medication with a full glass of milk.
- D. Expect your stools to be black and tarry.
Correct Answer: A
Rationale: The correct instruction that the nurse should include for a client prescribed Sucralfate is to take the medication on an empty stomach. Sucralfate works by forming a protective barrier over ulcers, which is most effective when the stomach is empty. Taking it with food or other medications may decrease its effectiveness. Instructing the client to take Sucralfate on an empty stomach helps ensure optimal therapeutic benefits. Choices B, C, and D are incorrect because increasing high-sodium foods is not related to Sucralfate therapy, taking the medication with a full glass of milk is not recommended as it may decrease its effectiveness, and the presence of black and tarry stools is not an expected outcome of Sucralfate.