Chapter 50 Miscellaneous Agents

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Chapter 50  Miscellaneous Agents

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. The nurse is caring for a patient diagnosed with gout who has elevated uric acid levels. Which medication will likely be administered?
a.
Allopurinol (Zyloprim)
b.
Disulfiram (Antabuse)
c.
Lactulose (Cephulac)
d.
Memantine (Namenda)

ANS: A
Allopurinol blocks the terminal step in uric acid formation by inhibiting the enzyme xanthine oxidase. Disulfiram, lactulose, and memantine do not lower uric acid levels.

DIF: Cognitive Level: Knowledge REF: p. 855 OBJ: 1
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

2. The nurse is providing information to a patient with chronic gout arthritis who is prescribed probenecid. Which information by the nurse is accurate regarding the action of this drug?
a.
It prevents uric acid crystal formation.
b.
It promotes uric acid excretion.
c.
It provides analgesia.
d.
It treats acute gout attacks.

ANS: B
Probenecid promotes renal excretion of uric acid and inhibits the reabsorption of urate in the kidney, which results in the reduction of uric acid in the blood. It is used to treat hyperuricemia and chronic gouty arthritis. The primary therapeutic outcome expected with probenecid therapy is prevention of acute attacks of gouty arthritis. Probenecid does not prevent formation of uric acid crystals or provide analgesia. Colchicines provide relief from acute attacks of gout.

DIF: Cognitive Level: Comprehension REF: p. 853 OBJ: 1 | 2
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Psychosocial Integrity

3. The nurse receives an order to administer colchicine 0.6 mg every 1 to 2 hours until the patient exhibits adverse effects. The nurse will monitor for which adverse effect?
a.
Diminished fever
b.
Diarrhea or nausea
c.
Increased urination
d.
Decrease in erythema

ANS: B
During an acute attack, initially 0.5 to 1.3 mg of colchicine are administered, followed by 0.6 mg every 1 to 2 hours until pain subsides, or nausea, vomiting, and diarrhea develop. Fever is not associated with gout, and colchicine does not reduce fever. Colchicine does not increase urinary output or frequency or affect erythema.

DIF: Cognitive Level: Comprehension REF: p. 851 OBJ: 1
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity

4. Which laboratory test result would the nurse observe when a patient has hepatotoxicity?
a.
Decreased bilirubin
b.
Increased albumin
c.
Decreased alkaline phosphatase
d.
Increased alanine aminotransferase (ALT)

ANS: D
The symptoms of hepatotoxicity are anorexia, nausea, vomiting, jaundice, hepatomegaly, splenomegaly, and abnormal liver function test results (elevated bilirubin, aspartate aminotransferase [AST], ALT, gamma glutamyl transpeptidase [GGT], alkaline phosphatase, prothrombin time). Bilirubin increases with hepatotoxicity. Albumin decreases with hepatotoxicity. Alkaline phosphatase increases with hepatotoxicity.

DIF: Cognitive Level: Application REF: p. 856 OBJ: 1
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Psychosocial Integrity

5. A patient with early Alzheimer’s disease is started on tacrine (Cognex), an acetylcholinesterase inhibitor. How will the nurse evaluate that the drug has been effective?
a.
Decrease in the patient’s agitation
b.
Improvement in the patient’s cognitive skills
c.
Slowing of disease progression by using a standardized tool
d.
Less frequent repetitive behaviors

ANS: B
Tacrine is an acetylcholinesterase inhibitor, which allows the accumulation of acetylcholine at the cholinergic synapses. Alzheimer’s disease is characterized by a loss of cholinergic activity. Tacrine improves cholinergic functioning in mild to moderate dementia. The therapeutic outcome of tacrine therapy is improvement in cognitive skills such as word recall, naming objects, language, word finding, and improved ability to carry out tasks. Tacrine improves cognitive function but not affective states. Tacrine may only treat symptoms and not halt progression of the disease. Tacrine does not affect repetitive behaviors.

DIF: Cognitive Level: Application REF: p. 854 OBJ: 1
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

 

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