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A patient presents to an emergency room complaining of palpitations and
irregular heartbeat. The advanced practice registered nurse (APRN) places the
patient on a cardiac monitor and observes atrial fibrillation. The APRN orders
dofetilide.
How should the APRN recommend this medication be taken? - ......answer.....YES
With food or an empty stomach
A 70-year-old male calls a clinic complaining of chest pain that started after
having sexual activity. He took sildenafil 50 mg about eight hours ago. He has
nitroglycerin 0.3 mg on hand.
How should the advanced practice registered nurse respond? - ......answer.....Do
not take the nitroglycerin and call 911
Taking the medications together can cause a serious drop in blood pressure
leading to cardiovascular collapse.
A patient diagnosed with bipolar disorder who is in a mental health clinic is
discussing the possibility of beginning lithium with an advanced practice
registered nurse (APRN). The patient expresses understanding and wishes to
proceed with treatment. The APRN explains to the patient that this medication
requires specific lab monitoring and wants to draw baseline labs. The patient
asks why the test is needed.
Which explanation should the APRN provide to this patient? - ......answer.....A
baseline blood urea nitrogen (BUN) and creatinine (CREA) level needs to be
drawn to assess kidney function prior to treatment.
,This drug can cause decreased renal function, and a baseline should be drawn
for future comparison.
An advanced practice registered nurse (APRN) is reviewing the medications that
will be commonly experienced with a new nurse to determine whether the drugs
are safe for the patients. The new nurse is given a scenario where a patient is
being prescribed sildenafil 25 mg po prn, a prototype drug for erectile
dysfunction.
Which patient may take this drug safely? - ......answer.....YES A 54-year-male with
a medical history of hypertension, mild eczema, and previous history of a
urolithiasis where all is well controlled and there are no current complications
A 30-year-old patient presents to a primary care clinic with a history of anxiety.
The advanced practice registered nurse reviews the mechanism of action by
which many neuropharmacological agents act and decides to prescribe
citalopram.
What is the mechanism of action of this medication? - ......answer.....YES
Influences receptor activity on target cells
Correct! This medication influences the activity in the receptors, and it targets
cells.
,A patient is admitted with a diagnosis of Huntington disease. On admission, the
patient exhibits uncontrolled twitching, difficulty walking, trouble swallowing,
confusion, and memory loss. The advanced practice registered nurse (APRN)
prescribes baclofen.
What is the mechanism of action of this medication? - ......answer.....NO
Modulates the effects of glutamate at NMDA receptors
YES Inhibits neurotransmitter GABA
NO Halts the breakdown of acetylcholine by acetylcholinesterase
Alters the synthesis and release of norepinephrine, serotonin, and dopamine
Incorrect. Cholinesterase inhibitors prevent the breakdown of acetylcholine by
acetylcholinesterase. They are used in patients with Alzheimer's.
Correct! Huntington's disease involves a deficiency of the neurotransmitters
acetylcholine and y-aminobutyric acid in the basal ganglia and extrapyramidal
system.
A 21-year-old patient accompanied by a parent comes to a clinic for an
emergency visit with an advanced practice registered nurse (APRN) following a
seizure. Upon interviewing the patient and the parent, the APRN determines that
the seizure is classified by marked impairment of consciousness and is followed
by a period of central nervous system (CNS) depression.
Which type of seizure is this patient experiencing? - ......answer.....Atonic
NO Myoclonic
YES Tonic-clonic
, Absence
Incorrect. Myoclonic seizures consist of a sudden muscle contraction that lasts
for just one second.
Correct! A tonic-clonic seizure is a type of seizure that is also called a
convulsion. This type of seizure can include muscle stiffness, loss of
consciousness, and body jerking.
A patient has been taking oral oxycodone every six hours for back pain during
the past three years. The patient suddenly decides to stop taking the pain
medication and is trying an alternative therapy without a clinician's approval.
Which risk is of clinical concern? - ......answer.....YES Physical dependence
Correct! The patient suddenly stopping the medication will cause physical
symptoms that can range from nausea to seizures.
An advanced practice registered nurse has diagnosed a 44-year-old male with
depression. A plan is developed to start treatment with medication. The patient
has a history of sexual dysfunction and is concerned about taking medication
that may worsen this condition.
Which antidepressant has the benefit of enhancing libido? - ......answer.....YES
Bupropion