Nokea
Zainab is taking lamotrigine (Lamictal) and presents to the clinic with fever and lymphadenopathy. Initial evaluation and treatment includes:
- A. Reassuring her she has a viral infection and to call if she isn't better in 4 or 5 days
- B. Ruling out a hypersensitivity reaction that may lead to multi-organ failure
- C. Rapid strep test and symptomatic care if strep test is negative
- D. Observation only, with further assessment if she worsens
Correct Answer: B
Rationale: Fever and lymphadenopathy suggest a serious lamotrigine hypersensitivity reaction.
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Which is a 5HT-receptor agonist?
- A. Ondansetron
- B. Ketanserine
- C. Sumatriptan
- D. Risperidone
Correct Answer: C
Rationale: Sumatriptan is a 5-HT1D agonist used in migraine.
When assessing a patient prior to starting a drug regimen it is often necessary to have a baseline kidney function study done. What might kidney impairment indicate in relation to drug therapy?
- A. Pharmacodynamics stable at the therapeutic dose
- B. Contraindication to the use of a drug
- C. Increased dosage of a drug
- D. Decreased adverse effects of a drug
Correct Answer: B
Rationale: Kidney impairment may contraindicate certain drugs due to reduced clearance, risking toxicity.
A nurse is caring for a client who is taking Propylthiouracil. For which of the following adverse effects of this medication should the nurse should be correct
- A. Bradycardia
- B. Insomnia
- C. Heat intolerance
- D. Weight loss
Correct Answer: A
Rationale: Propylthiouracil can cause bradycardia as a rare side effect, requiring monitoring.
The American Dietetic Association recommends pregnant women take a supplement including:
- A. 1,000 IU daily of vitamin D
- B. 2.4 mcg/day of vitamin B12
- C. 600 mcg/day of folic acid
- D. 8 mg/day of iron
Correct Answer: C
Rationale: 600 mcg/day of folic acid is recommended during pregnancy to prevent neural tube defects.
The nurse knows that which medication requires monitoring of thyroid function?
- A. Dofetilide
- B. Amiodarone
- C. Sotalol
- D. Flecainide
Correct Answer: B
Rationale: Amiodarone can cause hypo- or hyperthyroidism due to its iodine content, necessitating thyroid function monitoring.