Question 1

A nurse is teaching a client who has alzheimer's disease and their caregiver about mematine. Which of the following instruction should the nurse include?

Accepted Answer

Answer reason:  Memantine is cleared primarily by the kidneys and its elimination is affected by urine pH. Alkalinizing agents such as some antacids (e.g., sodium bicarbonate-containing products) can increase urine pH, reduce drug clearance, and raise serum levels, increasing the risk of adverse effects like dizziness, confusion, and hallucinations. Teaching should therefore include avoiding OTC antacids unless specifically approved and reviewing all OTC products with the provider/pharmacist. Renal monitoring and hydration can be relevant, but instructing routine increased fluids specifically “to improve renal excretion” is not a standard, targeted counseling point compared with avoiding urine-alkalinizing OTCs.

Question 2

A nurse is caring for a client who has a new prescription for pramipexole to treat parkinson's disease. The nurse should recognise that which the following laboratory test requires monitoring?

Accepted Answer

Answer reason: Pramipexole is eliminated primarily by the kidneys, so reduced renal function can increase drug exposure and the risk of adverse effects. Monitoring renal clearance helps determine whether dose adjustment is needed, especially in older adults or anyone with known kidney disease. Creatinine clearance (or an equivalent estimate of GFR) is the clinically relevant measure for renal dose consideration rather than inflammatory markers or thyroid testing. A CBC is not a routine monitoring requirement for this dopamine agonist unless another condition or medication warrants it.

Question 3

The nurse is caring for a client who has a new prescription for a drug. After receiving the first dose of the drug, the client experiences anaphylaxis. The nurse should identify that anaphylaxis represents which of the following results of the drug?

Accepted Answer

Answer reason: It is not a desired clinical outcome, so it cannot be a therapeutic effect. It is also not a paradoxical effect, which is an effect opposite of what is expected from the drug’s usual action. Toxicity generally reflects dose-related harmful effects from excessive levels/accumulation, whereas anaphylaxis can occur after a first dose due to immune-mediated mechanisms and is classified as an adverse effect.

Question 4

A nurse is speaking to a client who is taking sertraline and reports drinking grapefruit juice. The nurse explains that grapefruit juice inhibits an enzyme in the liver that is used to metabolize sertraline. The nurse should recognize the client's risk for which of the following?

Accepted Answer

Answer reason: If sertraline metabolism is reduced, the same dose can produce higher-than-intended blood levels and exaggerated pharmacologic effects. This increases the risk of adverse reactions such as serotonin toxicity, CNS effects, and other dose-related side effects. Reduced absorption would typically lower exposure, not raise it, making it inconsistent with enzyme inhibition described in the stem.

Question 5

Which drug is used in hypertension?

Accepted Answer

Answer reason: A dihydropyridine calcium channel blocker relaxes vascular smooth muscle, leading to peripheral vasodilation and sustained blood pressure reduction. Diazepam is a benzodiazepine used for anxiety/seizures, morphine is an opioid analgesic, and digoxin is primarily used for rate control in atrial fibrillation and symptomatic heart failure rather than primary blood pressure control. Therefore, the best choice among the options for treating hypertension is the calcium channel blocker.

Question 6

The treatment protocol for a client with acute lymphatic leukemia includes prednisone, methotrexate, and ... to:

Accepted Answer

Answer reason: Prednisone provides lympholytic effects and is commonly paired with antimetabolites to improve overall cytotoxic response. Using a regimen component to potentiate the antimetabolite aligns with standard multi-agent protocols rather than focusing on GI motility or pancreatic secretion. Preventing steroid adverse effects is managed with supportive measures, but that is not the primary purpose of including another antineoplastic in the protocol.

Question 7

Which is the drug of choice for malaria?

Accepted Answer

Answer reason: Quinine has been used for chloroquine-resistant malaria and remains an option in certain settings, often in combination regimens. Chloroquine is the standard choice where parasites are chloroquine-sensitive, making it a drug of choice in those regions. Artesunate is the preferred treatment for severe falciparum malaria and a key component of artemisinin-based combinations, so all listed agents can be considered drugs of choice in appropriate contexts.

Question 8

Which drug is anticoagulant?

Accepted Answer

Answer reason: This agent works by inhibiting vitamin K–dependent synthesis of clotting factors (II, VII, IX, X), making it a classic oral anticoagulant used for prevention and treatment of thromboembolism. By contrast, one listed alternative is an antiplatelet drug, and another is a thrombolytic that breaks down formed fibrin clots rather than preventing their formation. Therefore only this option matches the pharmacologic class being asked.

Question 9

Which drug is so important for sore throat ?

Accepted Answer

Answer reason: This medication provides reliable streptococcal coverage, is first-line in non-penicillin-allergic patients, and has a favorable safety profile. The macrolide choice is typically reserved for patients with true penicillin allergy or specific resistance/coverage considerations. The other listed agents are not appropriate first-line therapies for uncomplicated streptococcal pharyngitis because their spectra do not primarily target the usual pathogen or they are not recommended for routine use.

Question 10

Which analgesic is saf for pregnant woman.....?

Accepted Answer

Answer reason: NSAIDs such as ibuprofen and diclofenac are avoided especially in the third trimester due to risk of premature closure of the ductus arteriosus and oligohydramnios from reduced fetal renal perfusion. Aspirin at typical analgesic doses can increase maternal/fetal bleeding risk and is not the routine choice for pain control (low-dose use is a separate indication). Tramadol is an opioid with risks of maternal sedation and potential neonatal respiratory depression/withdrawal, so it is not preferred unless alternatives are unsuitable.

Question 11

Tranexamic Acid injection is used?

Accepted Answer

Answer reason: Clinically it is used for hemorrhage control such as heavy menstrual bleeding, trauma-related bleeding, and postpartum hemorrhage, and perioperative bleeding reduction. The infectious disease options are unrelated to its mechanism and therapeutic class. A common safety consideration is thromboembolic risk in susceptible patients because it promotes clot stability rather than treating infection.

Question 12

Which of the following remedy used in the treatment of insulin overdose?

Accepted Answer

Answer reason: Oral glucose (e.g., juice) is appropriate if the patient is awake and can swallow safely; intravenous dextrose is indicated for severe symptoms, altered mental status, or inability to take PO. This approach directly counteracts insulin’s glucose-lowering effect and is the fastest way to reverse symptoms. Oral hypoglycemic agents would worsen hypoglycemia, and general measures like avoiding diet changes or simply increasing fluids do not correct the acute low blood glucose.

Question 13

Megaloblastic anaemia due to vitamin B12 deficiency is treated by…..?

Accepted Answer

Answer reason: Vitamin B12 deficiency causes impaired DNA synthesis leading to megaloblastic anemia and may be associated with neurologic deficits, so treatment requires reliable repletion of cobalamin stores. Standard initial replacement for symptomatic deficiency or suspected malabsorption/pernicious anemia is parenteral cyanocobalamin at about 1000 µg IM, which bypasses the need for intrinsic factor and ensures absorption. Lower IM doses (e.g., 100 or 500 µg) are less consistently used for initial repletion in exam settings and may be inadequate for rapid replenishment. Oral therapy can work in some cases at high doses, but IM therapy is classically preferred when deficiency is due to absorption failure, making this option the best answer.

Question 14

What is true about pethidine?

Accepted Answer

Answer reason: Opioid analgesics are indicated for moderate-to-severe pain and can reduce the perception of visceral pain by acting primarily at μ-opioid receptors in the CNS. Pethidine (meperidine) provides analgesia and has historically been used for colicky/visceral pain, though its use is now limited in many settings due to its toxic metabolite (normeperidine) and adverse effect profile. It is not generally preferred over morphine because it has a shorter duration, less predictable benefit, and higher risk of neurotoxicity and serotonin syndrome (especially with MAOIs/SSRIs). Because at least one of the other statements is not reliably true, the “all of the above” option is incorrect.

Question 15

Fondaparinux binds to antithrombin and the complex inhibits the following clotting factor directly

Accepted Answer

Answer reason: Because it is too short to bridge antithrombin to thrombin, it does not directly inhibit factor IIa (unlike unfractionated heparin). By blocking Xa, it prevents conversion of prothrombin to thrombin and downstream fibrin clot formation. Options involving factor II or multiple vitamin K–dependent factors reflect other anticoagulant mechanisms (heparins/warfarin) rather than fondaparinux’s selective anti-Xa effect.

Question 16

Which of the following has weak folic acid antagonist activity?

Accepted Answer

Answer reason: Triamterene is a pteridine derivative and can weakly inhibit dihydrofolate reductase, which explains this folic acid antagonist activity. Amiloride, while also an ENaC blocker, is not classically associated with antifolate effects. Eplerenone (aldosterone antagonist) and indapamide (thiazide-like) do not act as folate antagonists.

Question 17

Clarithromycin tablets is used for ?

Accepted Answer

Answer reason: Clarithromycin is a standard component of multidrug therapy for Helicobacter pylori eradication in peptic ulcer disease (typically combined with a proton pump inhibitor and another antibiotic). It is not a primary treatment for syphilis, where penicillin is preferred, and it is not a standard antimalarial agent. “Diarrhea” is more commonly an adverse effect of antibiotics rather than an indication for clarithromycin.

Question 18

A nurse is preparing to administer a leucovorin calcium antidote to a patient who is having a reaction. Which of the following medications is the patient most likely having a reaction to?

Accepted Answer

Answer reason: Methotrexate inhibits dihydrofolate reductase, leading to impaired DNA synthesis and potentially severe myelosuppression and mucositis. Administering leucovorin replenishes reduced folate stores and protects normal cells during high-dose methotrexate exposure or overdose. Iron toxicity is treated with deferoxamine, warfarin reversal is vitamin K and/or PCC, and dopamine reactions are managed by dose adjustment/supportive measures rather than leucovorin.

Question 19

The drug of choice for preventing eclamptic convulsions is?

Accepted Answer

Answer reason: It has superior efficacy to benzodiazepines and phenytoin in preventing recurrent seizures and improving maternal outcomes, with an acceptable safety profile when appropriately monitored. Diazepam and phenytoin may be used only when magnesium is contraindicated or unavailable, but they do not provide the same prophylactic benefit and can cause more maternal/neonatal sedation or other adverse effects. Thiopentone is an anesthetic used for refractory seizures/intubation scenarios, not standard prophylaxis. Nursing management includes monitoring respiratory rate, deep tendon reflexes, and urine output and having calcium gluconate available for toxicity reversal.

Question 20

Hydroxyzine is used for?

Accepted Answer

Answer reason: It can be used as a non-benzodiazepine option when sedation is acceptable or when avoiding controlled substances is desired. It is not an antipyretic and does not treat the inflammatory pathways responsible for fever. It also has no role in glycemic control and is not an analgesic, though sedation may make patients feel less distressed.

Question 21

BP is controlled by?

Accepted Answer

Answer reason: This drug is a dihydropyridine calcium-channel blocker that relaxes arterial smooth muscle, lowering afterload and thereby reducing blood pressure. ORS is used for dehydration and does not treat hypertension. Paracetamol is an analgesic/antipyretic without meaningful antihypertensive effect, and “calcium” as a supplement is not a standard therapy to control elevated blood pressure.

Question 22

Tuberculosis is treated with?

Accepted Answer

Answer reason: This medication is a core first-line drug (commonly paired with rifampin, pyrazinamide, and ethambutol initially) and is also used for latent TB treatment. The other options are symptomatic/supportive drugs (analgesic/antipyretic, antihistamine, proton pump inhibitor) and do not eradicate TB infection. A key clinical consideration is monitoring for hepatotoxicity and giving pyridoxine to reduce peripheral neuropathy risk when indicated.

Question 23

Metronidazole is used to treat ?

Accepted Answer

Answer reason: A classic nursing/clinical association is treatment of amoebiasis and some cases of infectious diarrhea, and it is also used for C. difficile-associated colitis (a diarrheal illness). Diabetes is a metabolic/endocrine disorder and is not treated with this antibiotic. Cough and vomiting are symptoms with many causes and are not primary indications for metronidazole; moreover, nausea/vomiting can be adverse effects rather than a target condition.

Question 24

Ulcer is treated with?

Accepted Answer

Answer reason: This directly matches the mechanism of sucralfate, which adheres to ulcerated mucosa and supports local healing. Diclofenac is an NSAID that can worsen or precipitate peptic ulcer disease by inhibiting prostaglandins. Amoxicillin may be part of an H. pylori eradication regimen but alone is not the standard single-agent treatment, and amlodipine has no role in ulcer therapy.

Question 25

What is the mechanism of action of heparin?

Accepted Answer

Answer reason: This increases inhibition of thrombin (factor IIa) and factor Xa, preventing fibrin clot formation and clot propagation. “Inhibits vitamin K” describes warfarin, not heparin. While heparin reduces thrombin activity via ATIII, the primary described mechanism is activation/potentiation of antithrombin rather than direct thrombin blockade, and it is not primarily an antiplatelet agent.

Question 26

A male client comes to the emergency department complaining of sudden onset of diarrhea, anorexia, malaise, cough, headache, and recurrent chills. Based on the client's history and physical findings, the physician suspects legionnaires' disease. While awaiting diagnostic test results, the client is admitted to the facility and started on antibiotic therapy. What is the drug of choice for treating legionnaires' disease?

Accepted Answer

Answer reason:  Legionella is an atypical, intracellular respiratory pathogen that requires an antibiotic with good intracellular penetration. A macrolide provides appropriate activity against Legionella and is a classic first-line choice in many nursing exam keys. Rifampin is not used as monotherapy for this infection and is generally reserved as adjunct therapy in select severe cases due to rapid resistance risk. Amantadine targets influenza A, not bacteria, and amphotericin B treats systemic fungal infections rather than atypical pneumonias.

Question 27

After receiving an oral dose of codeine for an intractable cough, the male client asks the nurse, “How long will it take for this drug to work?” How should the nurse respond?

Accepted Answer

Answer reason: The question asks about onset of action (when it starts working), not peak effect or duration. Peak levels and maximal effect generally occur later (often closer to 1–2 hours), making longer time frames better fits for peak rather than onset. Teaching onset also supports safe monitoring for early opioid adverse effects such as sedation and respiratory depression soon after dosing.

Question 28

A client with acute asthma showing inspiratory and expiratory wheezes and a decreased expiratory volume should be treated with which of the following classes of medication right away?

Accepted Answer

Answer reason: Rapid-acting bronchodilators (typically short-acting beta-2 agonists) directly relax bronchial smooth muscle and provide the fastest symptom relief in an acute exacerbation. Corticosteroids help reduce airway inflammation but have a delayed onset and are adjuncts rather than immediate rescue therapy. Beta-adrenergic blockers can worsen bronchospasm by blocking beta-2 receptors and are contraindicated in acute asthma symptoms.

Question 29

Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnose asthma. When teaching the patient about this drug, the nurse should explain that it may cause?

Accepted Answer

Answer reason: This commonly presents as tremor, jitteriness, palpitations, and a sense of anxiety or nervousness, especially soon after inhalation or with higher doses. Sedation or lethargy is not an expected effect of this drug class. Albuterol also tends to shift potassium into cells, which can lead to hypokalemia rather than elevated potassium.

Question 30

Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what?

Accepted Answer

Answer reason: These agents reduce panic frequency and anticipatory anxiety and are appropriate for maintenance treatment. CNS depressants (e.g., benzodiazepines) may provide short-term relief but carry dependence risk and are not preferred as the primary adjunct to psychotherapy. Antipsychotics and anticonvulsants are not standard first-line treatments for uncomplicated panic disorder.

Question 31

A nurse is reviewing the laboratory findings of a client who has liver failure with ascites. The client takes spironolactone. Which of the following findings is an adverse effect of the medication?

Accepted Answer

Answer reason: Serum potassium 5.4 mEq/L Spironolactone is a potassium-sparing diuretic (aldosterone antagonist) that decreases potassium excretion in the distal nephron, making hyperkalemia a key adverse effect. A potassium level of 5.4 mEq/L is elevated and therefore clinically consistent with this risk. The other listed electrolytes are within typical reference ranges and are not characteristic adverse effects of this medication. In clients with liver failure/ascites, spironolactone is commonly used, so monitoring for rising potassium is essential to prevent dysrhythmias and neuromuscular symptoms.

Question 32

Panic disorder is treated with cognitive-behavioral techniques and deep breathing and relaxation, in addition to which of the following?

Accepted Answer

Answer reason: Pharmacologic therapy commonly includes anxiolytics for short-term relief (and often antidepressants as first-line maintenance), which aligns with this option’s intent. Antipsychotics are not routine treatments for primary panic disorder unless there is a comorbid psychotic disorder. CNS depressants as a broad class is too nonspecific and potentially unsafe given risks of sedation and dependence, whereas targeted anxiolytic therapy is the appropriate concept.

Question 33

A client diagnosed with panic disorder has been receiving medication therapy, which is being discontinued. A nurse would be alert for possible withdrawal symptoms if the client was receiving what?

Accepted Answer

Answer reason: This is especially relevant when a medication is being stopped and the nurse must anticipate and monitor for withdrawal. The other listed medications are antidepressants (SSRI/SNRI) that can cause a discontinuation syndrome, but the question’s classic, high-risk withdrawal concern in panic treatment is with benzodiazepines. Therefore the medication most associated with clinically significant withdrawal is the benzodiazepine listed.

Question 34

A nurse is caring for a patient with ‘Swine Flu’ and she has to give the Drug of choice for ‘Swine Flu’ and it is?

Accepted Answer

Answer reason: This choice is appropriate because it has established activity against influenza A and is standard first-line therapy for uncomplicated cases and for many hospitalized patients when susceptible. The other options are antivirals for different viruses: acyclovir targets herpesviruses, adefovir targets hepatitis B, and cidofovir is mainly used for CMV/adenovirus in select settings, none of which treat influenza. Therefore, the best drug of choice among the listed options is the neuraminidase inhibitor.

Question 35

After administering dihydroergotamine (Migranal) 1 mg subcutaneously to a client with a severe migraine headache the nurse should explain that relief can be expected within what time frame?

Accepted Answer

Answer reason: Expected clinical improvement typically begins within about 10–30 minutes after subcutaneous dosing. This makes a 15-minute expectation appropriate patient teaching for onset of relief. Time frames like 1–2 hours are more consistent with slower-onset routes or agents, while 5 minutes is faster than typical for subcutaneous absorption in most patients.

Question 36

A male client is receiving pilocarpine hydrochloride (Isopto Carpine) ophthalmic drops for glaucoma. He calls the nurse to ask the nurse why he has difficulty seeing at night. What explanation should the nurse provide?

Accepted Answer

Answer reason: With a constricted pupil, less light enters the eye, and the pupil cannot dilate effectively in low-light conditions, leading to reduced night vision. This effect is an expected pharmacologic consequence of parasympathomimetic therapy rather than lens opacification. A common misconception is that these drops dilate the pupil; the opposite occurs, which is why the problem is worse in darkness.

Question 37

A client who is taking an oral dose of tetracycline complains of gastrointestinal upset. What snack should the nurse instruct the client to take with the tetracycline?

Accepted Answer

Answer reason: The best way to lessen GI upset without impairing absorption is to take it with a small non-dairy, non-calcium snack and adequate water. Dairy-containing choices (milk in cereal, yogurt, and cheese) are high in calcium and are common causes of reduced tetracycline bioavailability. Therefore, the non-dairy toast and jelly option is preferred when a snack is needed.

Question 38

A 32-year-old female client has been taking lorazepam (Ativan) for her anxiety and is brought into the emergency department after taking 3fl day's worth at one time. What antagonist for benzodiazepines may be used in this case?

Accepted Answer

Answer reason: The specific reversal agent is a competitive antagonist at the benzodiazepine binding site, which can rapidly improve mental status when benzodiazepines are the primary intoxicant. The other options are antidotes for different toxidromes: naloxone reverses opioids, while epinephrine and atropine address cardiovascular or cholinergic problems rather than benzodiazepine receptor effects. Clinically, use requires caution because reversal in dependent patients or mixed overdoses can precipitate withdrawal seizures, so airway and supportive care remain central.

Question 39

The client taking benztropine (Cogentin) should be provided education on methods to manage which common adverse effect?

Accepted Answer

Answer reason: This leads to reduced peristalsis and drying of secretions, making bowel movements less frequent and harder to pass. Patient teaching therefore focuses on constipation prevention strategies such as adequate fluids, dietary fiber, and activity as tolerated. A common distractor is increased gastric motility, which is the opposite of the anticholinergic effect and would be more consistent with cholinergic stimulation.

Question 40

The client or family of a client taking tacrine (Cognex) should be taught to be observant for which of the following adverse effects that may signal that a possible overdose has occurred?

Accepted Answer

Answer reason: This leads to a “too much parasympathetic activity” picture with diaphoresis and increased secretions such as hypersalivation and drooling. In contrast, constipation, dry eyes, and tachycardia are more consistent with anticholinergic effects rather than cholinergic toxicity. Recognizing this symptom cluster is important because severe cholinergic toxicity can progress to bronchorrhea/bronchospasm and bradycardia, creating an airway and hemodynamic emergency.

Question 41

A patient is taking ibuprofen. The nurse understands that COX-1 and COX-2 inhibitors are different in that ibuprofen is more likely than celecoxib to cause which adverse effect?

Accepted Answer

Answer reason: This loss of protective prostaglandins increases the risk of gastritis, GI bleeding, and peptic ulceration. Celecoxib is relatively COX-2 selective, so it tends to spare COX-1 in the gastric lining and has a lower GI ulcer risk compared with nonselective NSAIDs. Constipation and metallic taste are not characteristic differentiators of COX selectivity, and fever is typically treated by NSAIDs rather than caused by them.

Question 42

A young client requires suturing of a laceration to the right forearm and the provider will use lidocaine (Xylocaine) with epinephrine as the local anesthetic prior to the procedure. Why is epinephrine included in the lidocaine for this client?

Accepted Answer

Answer reason: Epinephrine causes local vasoconstriction, which decreases blood flow in the injected area. Reduced perfusion slows systemic absorption of lidocaine, allowing it to remain near the nerve endings longer and thereby extending the duration of local anesthesia while also limiting peak systemic levels. This also helps reduce bleeding in the field, improving visibility for suturing. Increased vasodilation would shorten duration and increase systemic absorption, making it the opposite of the desired effect, and it does not directly prevent infection or hypotension.

Question 43

The client who is scheduled to have a minor in-office surgical procedure will receive nitrous oxide and expresses concern to the nurse that the procedure will hurt. Which of the following would be the nurse’s best response?

Accepted Answer

Answer reason: ’” Nitrous oxide produces conscious sedation with anxiolysis and some analgesia, altering the patient’s perception and emotional response to pain rather than guaranteeing complete absence of pain. Patients typically remain responsive and can maintain protective reflexes, so describing full unconsciousness is inaccurate. It also does not reliably “block pain signals” like a local anesthetic; instead it modulates central nervous system perception. Promising amnesia is not dependable with nitrous oxide alone and can create unrealistic expectations and distrust.

Question 44

An early sign(s) of levodopa toxicity is (are) which of the following?

Accepted Answer

Answer reason: Eye blinking/twitching and muscle twitching are classic early dyskinesia-type manifestations that may precede more severe neuropsychiatric effects. Orthostatic hypotension and GI upset can occur as adverse effects, but they are not as specific for toxicity as new or worsening dyskinesias. Drooling is more characteristic of Parkinson disease itself due to impaired swallowing rather than a toxicity signal.

Question 45

The emergency department nurse is caring for a client with a migraine headache. Which drug would the nurse anticipate administering to abort the client’s migraine attack?

Accepted Answer

Answer reason: Triptans are selective 5-HT1B/1D agonists that cause cranial vasoconstriction and inhibit release of inflammatory neuropeptides, making them a first-line choice for aborting moderate-to-severe migraines. Propranolol is used for migraine prophylaxis rather than immediate termination of an ongoing headache. Morphine is not a standard migraine abortive agent due to poorer efficacy and risks such as sedation, respiratory depression, and medication-overuse headache, while ibuprofen may help mild attacks but is less reliably effective for aborting significant ED-level migraine.

Question 46

It is important for the nurse teaching the patient regarding secobarbital (Seconal) to include which information about the drug?

Accepted Answer

Answer reason:  Secobarbital is a short-acting barbiturate hypnotic, so its sedative effect can wear off before the desired sleep period is complete. When the drug duration is shorter than the patient’s usual sleep time, early-morning awakening can occur as sedation dissipates. Teaching should therefore include that it may not maintain sleep through the night and can lead to interrupted sleep patterns. A common distractor is attributing prominent “hangover” daytime sedation to intermediate/longer-acting hypnotics, which is less characteristic of short-acting agents.

Question 47

A patient taking lorazepam (Ativan) asks the nurse how this drug works. The nurse should respond by stating it is a benzodiazepine that acts by which mechanism?

Accepted Answer

Answer reason: This increases neuronal hyperpolarization and decreases excitability, producing anxiolytic, sedative-hypnotic, anticonvulsant, and muscle-relaxant effects. General anesthesia with loss of consciousness is not the typical mechanism/effect at therapeutic doses and is more consistent with stronger CNS depressants. An epidural block describes a regional anesthetic technique, not a systemic benzodiazepine action.

Question 48

A patient is taking zolpidem (Ambien) for insomnia. The nurse prepares a care plan that includes monitoring of the patient for side effects/adverse reactions of this drug. Which is a side side effect of zolpidem?

Accepted Answer

Answer reason: Headache is a frequent reported side effect along with dizziness, drowsiness, and GI upset, so it is appropriate to monitor for it in a care plan. “Insomnia” is the indication being treated and is not a typical adverse effect to monitor for as a primary expected side effect. Laryngospasm and blood dyscrasias are not characteristic adverse reactions of zolpidem and would be atypical compared with expected CNS effects.

Question 49

During her yearly physical, a post-menopausal client describes the symptoms of dyspareunia and urinary tract infections. What medications may her physician prescribe her with post-menopausal atrophic vaginitis?

Accepted Answer

Answer reason:  Postmenopausal atrophic vaginitis is primarily caused by hypoestrogenism, leading to thinning of the vaginal epithelium, elevated vaginal pH, dryness, and increased susceptibility to irritation and recurrent UTIs. Replacing estrogen locally (or sometimes systemically) restores epithelial thickness, improves lubrication, and helps normalize the vaginal microbiome, which reduces dyspareunia and infection risk. This directly targets the underlying pathophysiology rather than only treating symptoms. The other listed agents are not standard therapies for vulvovaginal atrophy and would not correct estrogen-deficiency changes. Clinical practice commonly uses low-dose vaginal estrogen preparations for these complaints when not contraindicated.

Question 50

A patient is taking benztropine for Parkinson’s disease is experiencing worsening of symptoms. The nurse will anticipate the patient will benefit from?

Accepted Answer

Answer reason: Levodopa replenishes dopamine in the CNS, and carbidopa inhibits peripheral decarboxylation, increasing CNS availability while reducing peripheral adverse effects like nausea and orthostatic hypotension. Benztropine mainly helps tremor by decreasing cholinergic activity but is often insufficient as disease progresses. Simply stopping therapy for a week risks marked symptom rebound and impaired mobility. A dopamine agonist dose increase can help some patients, but levodopa/carbidopa is the most effective symptomatic treatment when symptoms are worsening despite anticholinergic therapy.

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