RN exams pharmacology practice questions set 11

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The correct answer is A: Relaxation of the detrusor muscle. Diphenhydramine, an anticholinergic drug, causes relaxation of the detrusor muscle, leading to urinary retention. In benign prostatic hyperplasia, the enlarged prostate already causes obstruction, exacerbating the urinary retention. Therefore, the relaxation of the detrusor muscle due to diphenhydramine worsens the situation by further impairing bladder emptying. Explanation for other choices: B: Constriction of the bladder external sphincter - This would lead to urinary retention, not relieve it. C: Constriction of the prostate capsule - Constriction of the prostate capsule would not relieve urinary retention in benign prostatic hyperplasia. D: Relaxation of the bladder internal sphincter - Relaxation of the bladder internal sphincter would promote bladder emptying, which is opposite to the clinical presentation of urinary retention in this case.

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The correct answer is D: Prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist. Rationale: 1. Amoxicillin/clavulanate is a recommended first-line antibiotic for recurrent otitis media due to its broad spectrum coverage. 2. Referring the child to an otolaryngologist is necessary for further evaluation and management of recurrent ear infections, as this child has had multiple episodes in a year. Summary of other choices: A: Prescribing both high dose amoxicillin and the influenza vaccine is not the best option as the child already has recurrent ear infections and needs a more comprehensive approach. B: Beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole is not recommended as a first-line treatment for recurrent otitis media. C: Prescribing ceftriaxone IV with benzocaine ear drops is not the optimal choice for managing recurrent ear infections in a 2-year-old.

Correct answer:

The correct answer is A: Relaxation of the detrusor muscle. Diphenhydramine, an anticholinergic drug, causes relaxation of the detrusor muscle, leading to urinary retention. In benign prostatic hyperplasia, the enlarged prostate already causes obstruction, exacerbating the urinary retention. Therefore, the relaxation of the detrusor muscle due to diphenhydramine worsens the situation by further impairing bladder emptying. Explanation for other choices: B: Constriction of the bladder external sphincter - This would lead to urinary retention, not relieve it. C: Constriction of the prostate capsule - Constriction of the prostate capsule would not relieve urinary retention in benign prostatic hyperplasia. D: Relaxation of the bladder internal sphincter - Relaxation of the bladder internal sphincter would promote bladder emptying, which is opposite to the clinical presentation of urinary retention in this case.

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The correct answer is B: Atrial fibrillation. Atrial fibrillation is a common arrhythmia characterized by rapid, irregular heartbeats that can lead to tachycardia. In atrial fibrillation, the atria quiver instead of contracting effectively, leading to an irregular heart rhythm and increased heart rate. This condition can cause tachycardia due to the ineffective pumping of blood by the heart. Incorrect choices: A: Hypertrophic cardiomyopathy - This disorder can cause heart muscle thickening, leading to decreased ventricular filling and potentially causing arrhythmias, but it is not directly associated with tachycardia. C: Mitral regurgitation - This condition can lead to an enlarged left atrium and decreased cardiac output, but tachycardia is not a direct result of mitral regurgitation. D: Mitral stenosis - This condition can cause increased pressure in the left atrium and pulmonary congestion, but t

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The correct answers are i. Keep the patient’s call light within reach, iii. Avoid use of throw rugs, and iv. Maintain the patient’s bed in a low position. 1. Keeping the call light within reach ensures the patient can easily call for assistance, reducing the risk of falls. 2. Avoiding throw rugs prevents tripping hazards that can lead to falls. 3. Maintaining the bed in a low position reduces the risk of injury if the patient falls out of bed. The incorrect choices: - Choice B includes answer 3 (Avoid use of throw rugs), which is correct, but also includes answer 6 (Provide a cane or walker for ambulation), which is not specific to fall prevention. - Choice C includes answer 2 (Apply a soft vest restraint when the patient is in bed), which can increase the risk of falls due to restricted movement. - Choice D includes answers that are not directly related to fall prevention, such as 2 (Apply a soft vest

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The correct response is D: “Taking St. John’s wort with Zoloft may cause severe interactions and is not recommended.” Rationale: 1. St. John's wort is known to affect serotonin levels, similar to SSRIs like Zoloft. 2. Combining St. John's wort with SSRIs can lead to serotonin syndrome, a potentially life-threatening condition. 3. The nurse should advise against combining these medications due to the risk of adverse interactions. 4. This response prioritizes patient safety and provides clear guidance on the potential harm of the combination. Summary: A: Incorrect. This response is too casual and does not address the potential interactions between St. John's wort and Zoloft. B: Incorrect. Encouraging the patient to stop Zoloft abruptly is not safe and overlooks the risk of interactions. C: Incorrect. This response is vague and does not emphasize the seriousness of potential interactions.

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Cholestyramine (Questran) is a bile acid sequestrant used to lower cholesterol levels in the blood. To prevent clumping and sticking to the glass when mixing the powder, the nurse will suggest mixing the powder with food or fruit, or at least 4 to 6 ounces of fluid. This method helps to evenly disperse the powder and prevent clumping, making it easier for the patient to consume the medication. Mixing the powder with a carbonated soda drink (choice A) may not be suitable as the effervescence of the soda could affect the medication's stability. Adding the powder to any liquid and stirring vigorously (choice B) may not dissolve the powder effectively. Taking the powder dry on a spoon followed by a glass of water (choice E) may be difficult for the patient to swallow and may not distribute the medication evenly. Mixing with food or fluid provides a more palatable and effective method for administering Questr

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The correct answer is D: Induction of powerful uterine contracture. Ergonovine is a uterotonic agent that works by stimulating uterine contractions, which helps control postpartum hemorrhage due to uterine atony. The drug acts directly on the smooth muscle of the uterus, leading to increased tone and decreased bleeding. A: Selective constriction of uterine arteries is incorrect because ergonovine primarily acts on the uterine muscle itself, not the blood vessels supplying the uterus. B: Endothelin release in the uterine vascular bed is incorrect as ergonovine does not directly affect endothelin release. C: Platelet aggregation in the uterine vascular bed is incorrect as ergonovine's action is not related to platelet aggregation but rather to uterine muscle contraction. In summary, the therapeutic effect of ergonovine in this patient is mediated by its ability to induce powerful uterine contr

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Cleaning equipment between each enteral feeding is vital to prevent bacterial contamination, as residual formula can foster microbial growth, risking infections like gastroenteritis in a client already nutritionally compromised. While limiting hang time is important, evidence suggests a 4-hour maximum, not 8, to minimize spoilage-though this isn't the focus here. Refrigerating unused feeding preserves its integrity, preventing degradation or bacterial proliferation, which is critical for safety. Keeping the insertion site clean reduces infection risk at the tube entry, a common complication in enteral therapy. Cleaning equipment stands out as a proactive step the wife can take between feedings, directly impacting hygiene and client safety, whereas other points address storage or site care, which, while essential, are secondary to the immediate post-feeding action of equipment maintenance in this context.

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Phenytoin and carbamazepine are antiepileptic drugs with a shared mechanism: they stabilize neuronal membranes by preventing sodium influx through fast sodium channels, reducing excitability and controlling seizures, particularly in partial and tonic-clonic types. Both induce hepatic cytochrome P450 enzymes, accelerating metabolism of other drugs, not inhibiting it. Phenytoin exhibits zero-order elimination at high doses due to enzyme saturation, while carbamazepine follows first-order kinetics, so this isn't a shared trait. They reduce the efficacy of oral contraceptives by inducing their metabolism, not enhancing them. Safety in pregnancy is questionable, with both linked to teratogenicity (e.g., fetal hydantoin syndrome). The sodium channel blockade is the fundamental property uniting their therapeutic effects, making it the key characteristic they share, critical to their role in epilepsy management.