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Which patient may require a higher-than-expected dose of an opioid analgesic?
- A. A patient 3 days after surgery.
- B. A patient with cancer.
- C. A patient with hypotension.
- D. A patient with a concussion.
Correct Answer: B
Rationale: The correct answer is B: A patient with cancer. Patients with cancer often have higher pain levels due to tumor growth, nerve compression, or treatment side effects, requiring higher opioid doses for adequate pain relief. Patients 3 days after surgery (A) may need opioids initially but typically require lower doses as pain decreases. Patients with hypotension (C) may be more sensitive to opioids, necessitating lower doses. Patients with a concussion (D) may have altered mental status, making opioid use risky.
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The nurse evaluates an improvement in the patient's heart failure (HF) status based on what assessment finding?
- A. Improved mental status.
- B. Using fewer pillows at night.
- C. Increased skin turgor.
- D. Heart rate regular.
Correct Answer: B
Rationale: The correct answer is B: Using fewer pillows at night. This indicates decreased fluid retention, a common symptom of heart failure. Improved mental status (A) may not directly correlate with HF improvement. Increased skin turgor (C) is more related to dehydration. A regular heart rate (D) is a positive sign but not specific to HF improvement.
The nurse assisting with Phase 1 drug studies is talking with a woman who asks, 'Why can't I participate in this study?' What would be the nurse's best response?
- A. Women are more prone to adverse effects from medications.
- B. Drugs pose a greater risk to women of reproductive age.
- C. Drugs affect women differently than they affect men.
- D. Drugs are tested only on men because they are stronger.
Correct Answer: B
Rationale: The correct answer is B: Drugs pose a greater risk to women of reproductive age. This answer is based on the fact that women of reproductive age may be at higher risk when participating in drug studies due to potential harm to a developing fetus. Women's hormonal fluctuations can also affect drug metabolism and response, making them more vulnerable to adverse effects.
Incorrect choices:
A: Women are not inherently more prone to adverse effects; it depends on various factors.
C: While drugs can indeed affect men and women differently, this is not the primary reason for excluding women from studies.
D: Excluding women from drug studies solely because they are 'stronger' is not ethical or scientifically valid.
What drug would the nurse administer to treat a patient diagnosed with bronchospasm associated with chronic obstructive pulmonary disease (COPD)?
- A. Glycopyrrolate.
- B. Ipratropium.
- C. Atropine.
- D. Flavoxate.
Correct Answer: B
Rationale: The correct answer is B: Ipratropium. Ipratropium is an anticholinergic bronchodilator that helps relax the muscles in the airways, making it effective in treating bronchospasm in COPD. Glycopyrrolate (A) is also an anticholinergic but not commonly used for bronchospasm. Atropine (C) is not typically used for COPD-related bronchospasm. Flavoxate (D) is a urinary antispasmodic and not indicated for bronchospasm.
Identify one indicator for a narcotics antagonist to be prescribed.
- A. Treatment of narcotic dependence.
- B. Treatment of alcohol dependence.
- C. Reversal of tachycardia.
- D. Reversal of bronchoconstriction.
Correct Answer: A
Rationale: The correct answer is A: Treatment of narcotic dependence. Narcotics antagonists are prescribed to counteract the effects of narcotics in the body. By blocking the receptors that narcotics bind to, these antagonists help in the treatment of narcotic dependence by reducing cravings and withdrawal symptoms. Choices B, C, and D are incorrect because narcotics antagonists are not indicated for the treatment of alcohol dependence, reversal of tachycardia, or bronchoconstriction. The key indicator for prescribing a narcotics antagonist is its specific role in addressing narcotic dependence, making choice A the correct option.
A patient exhibits ptosis of both eyes and the provider orders edrophonium (Tensilon). The nurse notes immediate improvement of the ptosis. The nurse understands that this patient most likely has which disorder?
- A. Myasthenia gravis.
- B. Cerebral palsy.
- C. Multiple sclerosis.
- D. Muscle spasm.
Correct Answer: A
Rationale: The correct answer is A: Myasthenia gravis. Edrophonium is a reversible acetylcholinesterase inhibitor that improves muscle strength in patients with myasthenia gravis due to its ability to increase acetylcholine levels at the neuromuscular junction. The immediate improvement of ptosis after administration of edrophonium suggests a diagnosis of myasthenia gravis, a disorder characterized by muscle weakness and fatigability. Cerebral palsy (B) is a non-progressive neurological disorder not typically associated with ptosis and not responsive to edrophonium. Multiple sclerosis (C) is an autoimmune demyelinating disorder that does not typically present with ptosis. Muscle spasm (D) does not explain the ptosis and would not improve with edrophonium.