RN exams pharmacology practice questions set 20

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The correct answer is C because sharp swings from a cheerful mood to an aggressive state are not typically associated with barbiturate intoxication. Barbiturates generally depress the central nervous system, leading to symptoms such as stupor, confusion, and slowed thinking. Choice A includes symptoms like vertigo and myasthenia, which can be experienced during barbiturate intoxication. Choice B includes symptoms like perceptual distortions, behavior changes, and speech excitation, which are commonly seen in barbiturate intoxication. Choice D mentions sleep with subsequent weakness and headaches, which are also common symptoms of barbiturate intoxication. Overall, the incorrect choices describe symptoms that align with barbiturate intoxication, making C the outlier.

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Correct Answer: A Rationale: 1. Hydrocodone is an opioid analgesic that belongs to the group of opioids. 2. Opioids like hydrocodone bind to opioid receptors in the brain, spinal cord, and other parts of the body. 3. By binding to these receptors, hydrocodone modulates pain perception and response. 4. This mechanism of action results in the alleviation of pain in individuals. 5. Therefore, choice A is correct as it accurately describes how hydrocodone works. Summary: - Choice B is incorrect as it describes the mechanism of tricyclic antidepressants, not opioids like hydrocodone. - Choice C is incorrect as it refers to the mechanism of action of NSAIDs, not opioids. - Choice D is incorrect as it describes the mechanism of local anesthetics, not opioids.

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Intravenous injection is a route of administration where a substance is delivered directly into the veins. While it is true that intravenous injection tends to produce more immediate adverse reactions, can lead to high drug concentrations, and poses a risk of penetrating an artery instead of a vein, it is not considered convenient, safe, or economical compared to other routes of administration. Intravenous injections require skilled personnel to administer, careful monitoring, and specialized equipment, which can add to the cost and complexity of treatment. Additionally, there is always a potential risk of infection or other complications associated with intravenous injection, which can make it less safe compared to other routes like oral or topical administration.

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Step-by-step rationale for choice B: 1. Spironolactone is a mineralocorticoid receptor antagonist. 2. It blocks aldosterone receptors in the kidneys. 3. Aldosterone is a hormone that promotes sodium and water retention, leading to increased blood volume and pressure. 4. By blocking aldosterone receptors, spironolactone reduces sodium and water retention, helping to decrease blood volume and pressure in heart failure patients. Summary of why other choices are incorrect: A: Inhibiting sodium reabsorption in the kidneys is the mechanism of action of loop diuretics, not spironolactone. C: Spironolactone actually increases potassium retention, not excretion. D: Increasing cardiac contractility is the mechanism of action of positive inotropic agents, not spironolactone.

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The correct answer is A: Inhibiting the reuptake of serotonin in the brain. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), works by blocking the reuptake of serotonin in the brain, leading to increased levels of serotonin available in the synaptic cleft. This helps regulate mood and alleviate symptoms of depression. Summary: - B: Increasing the release of norepinephrine and dopamine: This is incorrect as fluoxetine specifically targets serotonin reuptake, not norepinephrine or dopamine. - C: Blocking serotonin receptors: This is incorrect as fluoxetine does not block serotonin receptors but rather inhibits its reuptake. - D: Inhibiting the reuptake of dopamine: This is incorrect as fluoxetine primarily affects serotonin reuptake, not dopamine.

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The nurse monitors the activated partial thromboplastin time (aPTT) to check the effectiveness of heparin therapy in a patient with a pulmonary embolism. Heparin works by inhibiting the clotting cascade, specifically by potentiating the activity of antithrombin III, which inactivates thrombin and factor Xa. Monitoring the aPTT helps determine the appropriate dosage of heparin to maintain therapeutic levels of anticoagulation and prevent clot formation without increasing the risk of bleeding. The desired therapeutic range for aPTT when a patient is on heparin therapy is usually 1.5 to 2.5 times the control value. Monitoring aPTT levels regularly helps ensure that the patient is receiving the correct dose of heparin for effective treatment of the pulmonary embolism.

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The correct answer is D because discontinuing digoxin and starting losartan is the appropriate therapeutic adjustment for a 65-year-old man with acute distress and cardiac failure. Digoxin is not recommended in the acute phase of heart failure as it can worsen symptoms. Losartan, an angiotensin II receptor blocker, is beneficial in heart failure by improving outcomes and reducing hospitalizations. Discontinuing digoxin eliminates the risk of toxicity and adverse effects. Other choices are incorrect because adding potassium supplementation (Choice A) can increase the risk of hyperkalemia, adding atropine (Choice B) is not indicated in heart failure, and increasing furosemide dose (Choice C) may lead to electrolyte imbalances without addressing the underlying cause.

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Spironolactone, a potassium-sparing diuretic, treats hypertension by blocking aldosterone, reducing sodium reabsorption while retaining potassium . This risks hyperkalemia (>5.0 mEq/L), causing arrhythmias or muscle weakness, especially in renal impairment. Monitoring potassium closely ensures early detection, critical for safety. Sodium may drop mildly but isn't the primary concern. Calcium and magnesium aren't directly affected. Potassium's elevation aligns with spironolactone's mechanism, distinct from other diuretics that deplete it, making it the priority electrolyte. Regular checks (e.g., serum levels) prevent toxicity, particularly in hypertension where cardiac stability is key, thus B is the nurse's focus for vigilant monitoring and timely intervention.

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The correct answer is D because discontinuing digoxin and starting losartan is the appropriate therapeutic adjustment for a 65-year-old man with acute distress and cardiac failure. Digoxin is not recommended in the acute phase of heart failure as it can worsen symptoms. Losartan, an angiotensin II receptor blocker, is beneficial in heart failure by improving outcomes and reducing hospitalizations. Discontinuing digoxin eliminates the risk of toxicity and adverse effects. Other choices are incorrect because adding potassium supplementation (Choice A) can increase the risk of hyperkalemia, adding atropine (Choice B) is not indicated in heart failure, and increasing furosemide dose (Choice C) may lead to electrolyte imbalances without addressing the underlying cause.

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The correct answer is D: Venlafaxine. Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI), which works by blocking the reuptake of serotonin and norepinephrine in the brain, thereby increasing the levels of these neurotransmitters. This helps alleviate symptoms of depression. Rationale: 1. Sertraline (A) is a selective serotonin reuptake inhibitor (SSRI), primarily targeting serotonin. 2. Amitriptyline (B) is a tricyclic antidepressant that primarily acts on norepinephrine and serotonin reuptake, but it is not as selective as Venlafaxine. 3. Citalopram (C) is an SSRI that primarily targets serotonin reuptake, not norepinephrine. In summary, Venlafaxine is the correct choice as it specifically inhibits both serotonin and norepinephrine reuptake