Nokea
You are managing the care of a patient recently diagnosed with benign prostatic hyperplasia (BPH). He is taking tamsulosin but reports dizziness when standing abruptly. The best option for this patient is:
- A. Continue the tamsulosin because the side effect will resolve with continued treatment.
- B. Discontinue the tamsulosin and start doxazosin.
- C. Have him double his fluid intake and stand more slowly.
- D. Prescribe meclizine as needed for the dizziness.
Correct Answer: C
Rationale: Orthostatic hypotension from tamsulosin is managed by rising slowly and ensuring hydration.
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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.
A patient on imipenem/cilastatin is at risk for which adverse effect?
- A. Allergic reaction
- B. Seizures
- C. C. difficile infection
- D. All of the above
Correct Answer: D
Rationale: Imipenem/cilastatin can cause allergic reactions, seizures (neurotoxicity), and C. difficile infection, making all potential risks.
Dopamine is:
- A. Alpha and beta agonist
- B. Beta agonist
- C. A beta blocking agent
- D. Alpha blocking agent
Correct Answer: A
Rationale: Dopamine activates alpha and beta receptors.
The nurse is preparing a medication that is new to the market and cannot be found in the nurse's drug guide. Where can the nurse get the most reliable information about this medication?
- A. Package insert
- B. Another nurse
- C. Drug manufacturer
- D. Physician
Correct Answer: A
Rationale: The most reliable information about the drug can be found on the package insert supplied by the manufacturer because it was prepared according to strict Food and Drug Administration (FDA) regulations. Asking another nurse or the physician is not reliable and cannot be verified as accurate. It would not be realistic to call the drug manufacturer for information.
A patient with a history of opioid abuse will be discharged home with buprenorphine to help prevent relapse. Which product will the nurse anticipate the provider to order?
- A. Buprenex
- B. Suboxone
- C. Subutex
- D. Vivitrol
Correct Answer: A
Rationale: Buprenex is buprenorphine with low abuse potential for maintenance; Suboxone has naloxone added. Buprenex is an agonist-antagonist opioid that can be used for detoxification and maintenance therapy because it has a low potential for abuse.