Nokea
Which patient-teaching instructions are appropriate for a patient taking an antidysrhythmic drug? (Select all that apply.)
- A. Do not chew or crush extende
- B. release forms of medication.
- C. Take the medication with food if gastrointestinal distress occurs.
- D. If a dose is missed, the missed dose should be taken along with the next dose that is due to be taken.
Correct Answer: A
Rationale: A. Do not chew or crush extended-release forms of medication. This is an appropriate instruction because chewing or crushing extended-release forms of medication can alter their intended time-release action, leading to an overdose or underdose.
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For the patient taking acetaminophen, what should the nurse do? (Select all that apply.)
- A. Monitor routine liver enzyme tests.
- B. Encourage the patient to check package labels of over-the-counter drugs to avoid overdosing.
- C. Report side effects immediately, as toxicity can cause severe hepatic damage.
- D. Teach the female patient that oral contraceptives can increase the effect of acetaminophen.
Correct Answer: D
Rationale: Acetaminophen is metabolized in the liver, and excessive doses can lead to hepatotoxicity. Routine monitoring of liver enzymes is essential to detect early signs of liver damage. Patients should also be educated to check the acetaminophen content in over-the-counter medications to avoid accidental overdose. Reporting side effects promptly is crucial, as acetaminophen toxicity can cause severe and potentially fatal liver damage. While oral contraceptives can affect drug metabolism, they do not significantly increase the effects of acetaminophen. Therefore, the correct actions are to monitor liver enzymes, educate about over-the-counter medications, and report side effects.
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.
A patient is experiencing mucositis (stomatitis) after receiving chemotherapy. Which symptomatic treatments will be appropriate? (Select all that apply.)
- A. Frequent mouth rinses
- B. Antiemetics
- C. Topical anesthetics
- D. Stress reduction
Correct Answer: A
Rationale: Mucositis, or stomatitis, is a painful inflammation of the mucous membranes caused by chemotherapy. Frequent mouth rinses with saline or baking soda solutions help keep the mouth clean and promote healing. Topical anesthetics, such as lidocaine, can provide pain relief. Stress reduction techniques, such as relaxation or mindfulness, may help manage the discomfort associated with mucositis. Antiemetics are used to control nausea and vomiting, which are not directly related to mucositis. Antibiotics are only necessary if there is a secondary infection, which is not mentioned in this scenario.
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.
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.