Nausea, Heartburn, Indigestion, Upset Stomach, Diarrhea
what is the difference between docusate sodium and bisacodyl?
Docusate Sodium (colace) is a surfactant laxative (stool softener) that works by adding moisture to stool, making it easier to pass, while bisacodyl (dulcolax) is a stimulant laxative that works by causing muscle contractions in the intestines to produce a bowel movement.
What is the on-set time of Lispro Insulin?
15 to 30 minutes. (Rapid Acting Insulin)
We all know by now to avoid leafy greens while on an anticoagulant. Which foods does not increase the risk of bleeding?
A. Ginkgo biloba
B. Ginger
C. Black Pepper
D. Garlic
C. Black Pepper
As the nurse you would educate your patient taking MAOIs to avoid this type of food to avoid a hypertensive crisis.
Tyramine-rich Foods
What medication is safe to be administered with Spironolactone?
A. Potassium Supplements
B. ACE Inhibitors
C. Angiotensin Receptor Blockers ARBs
D. Gabapentin
D. Gabapentin
Combining spironolactone with the other drugs listed can lead to dangerous increases in potassium levels (hyperkalemia), kidney problems, and reduced effectiveness of the medications
Your patient with a history of inflammatory bowel disease was just diagnosed with C.Diff from the long term use of antibiotics. Why are Loperamide and Diphenoxylate-Atropine contraindicated?
There is an increased risk of megacolon leading to complications like bowel perforation.
Secondly, these medications working by slowing down the digestive system, which can prevent the body from clearing the bacterial infection.
Your are about to give NPH insulin to your patient. While reviewing all the right of medication administration you notice your insulin is cloudy. What is your next step as the nurse?
Administer the NPH.
NPH and premixed insulins are the only insulins that should appear cloudy.
Your patient came into the ED with R sided weakness, L gaze, and word finding. Head CT was negative for a bleed. What medication may the ER physician order?
A. Clopidogrel (Plavix)
B. Heparin Drip
C. Asprin
D. Alteplase
D. Alteplase (tPA)
You are taking care of a 78 year old African American female with Schizophrenia. She has been taking first-generation antipsychotics for years. While in her presence you notice she is constantly chewing but has nothing in her mouth. What is this extrapyramidal side effect called?
Tardive Dyskinesia
Can occur months to years after the start of therapy and can improve or be permanent. Patients need to be evaluated 12 months after the start of therapy and every 3 months thereafter.
A. Valsartan
B. Amlodipine
C. Metoprolol
D. Enalapril
D. Enalapril
The cough is caused by the accumulation of bradykinin, a substance that ACE inhibitors prevent the body from breaking down. The only effective treatment is to stop the ACE inhibitor.
A patient with heart failure needs a recommendation on which laxative to use. Which option should the nurse tell the patient to avoid?
A.Psyllium
B.Bisacodyl
C.Sodium Phosphate
D.Polyethylene Glycol
C.Sodium Phosphate
The absorption of sodium can cause increased fluid retention, potentially exacerbating fluid retention.
Your diabetic patient on Metformin was just ordered a CT w/ contrast. What would you want to ask your patient?
When was the last time you took your Metformin?
- If taking metformin, stop medication 24-48hrs prior to procedure and resume 48 hours after scan, as long as labs shown normal kidney function.
What is the antidote to Heparin incase of an emergency?
Protamine.
Protamine binds with heparin and forms a heparin-protamine complex that as no anticoagulation properties.
Your patient was admitted to the hospital and is prescribed Escitalopram (Lexapro). You notice in his EMR he is already taking Sertraline (Zoloft), as his nurse you know they are at an increased risk of what complication when taking more than one SSRI?
Serotonin Syndrome
Can begin 2 to 72 hours after starting treatment and can be lethal.
Manifestations: Confusion, agitation, delirium, seizures, tachycardia, labile blood pressure, diaphoresis, fever, nausea/vomiting, diarrhea, coma.
What is the therapeutic range of digoxin?
0.5 to 2
Your patient has been admitted for the stomach flu and has been experiencing frequent diarrhea and vomiting leading to electrolyte imbalances. You have been treating them with IV hydration and Ondansetron 4mg Q6hrs PRN. When the doctor orders an EKG, what are they looking for.
Prolonged QT
A prolonged QT interval can lead to Torsades de Pointes (a deadly dysrhythmia)
How does Insulin and Dextrose aid in the treatment of Hyperkalemia?
Insulin moves potassium out of the blood and into the cells (along with glucose). The dextrose then helps prevent hypoglycemia.
Your patient just received Alteplase. Which assessment finding is most concerning to you.
A. Brusing at the IV site.
B. Altered Mental Status.
C. Pink tinged urine in the Foley catheter bag.
D. Bleeding gums
B. Altered Mental Status.
Any change in cognition can be a sign of hemorrhagic conversion.
You notice your patient is on Lithium for Bipolar disorder and Torsemide. As the nurse caring for this patient what is your initial concern (why) and how would you educate the patient.
Hyponatremia (puts the patient at an increased risk of lithium toxicity)
Educate the patient on adequate oral fluid intake.
What is the maximum number of sublingual nitro tablets that can be taken for a anginal attack?
3 Tablets
1st tablet, wait 5 minutes. If not resolved call 911. Then take 2nd tablet, then wait 5 minutes. If still not resolved take the 3rd and. final tablet.
What type of laxative is approved for use in patients with Ulcerative Colitis?
A. Bulk-Forming Laxatives
B. Stimulant Laxatives
C. Surfactant Laxatives
D. Osmotic Laxatives
A. Bulk-Forming Laxatives
A patient comes into the clinic with nausea, vomiting, and abdominal pain that radiates to the back, their medical hx includes diabetes being treated with diet, exercise, and semaglutide. What labs do you expect the doctor to order?
A. PT and INR
B. Serum lipase
C. BNP & Troponin
D. Lactic Acid
B. Serum lipase.
Pancreatitis is a common complication of semaglutide. Serum lipase rises significantly in the presence of pancreatitis.
Your patient cannot take heparin due to a history of heparin-induced thrombocytopenia. What do you expect the doctor to prescribe to prevent thrombosis?
A. Dabigatran
B. Argatroban
C. Bivalirudin
D. Desirudin
B. Argatroban: used to prevent/treat thrombosis in clients who cannot take heparin due to a history of heparin-induced thrombocytopenia.
Dabigatran: Prevents stroke or embolism in patients w/ a fib or to prevent/treat DVT and PE
Bivalirudin: Given w/ aspirin for clients undergoing PCI
Desirudin: Given to patients having hip replacements to prevent DVT.
A nurse is providing discharge teaching to a patient just starting clozapine. What would the nurse want to include?
A. Make sure to eat a diet high in carbohydrates.
B. Your platelet count is expected to decrease.
C. You need to have your WBC checked frequently.
D. Developing hand tremors is very likely.
C. You need to have your WBC checked frequently.
Clozapine is linked to an increased risk of fatal agranulocytosis. Patients need their WBC checked weekly and should notify their doctor immediately for fevers, cough, and other flu like symptoms.
A nurse is reviewing the medical record of a client about to start propranolol to treat her hypertension. Which is a contraindication for taking the medication?
A. Glaucoma
B. Tachycardia
C. Asthma
D. Diabetes
C. Asthma
Propanolol in a nonselective beta-adrenergic blocker that blocks both beta 1 and beta 2 receptors. Blockade of beta 2 receptors in the lungs causes bronchoconstriction, therefore it is contraindicated.