Question 1

Which condition(s) and/or circumstance(s) warrant caution when colchicine is used for a patient with gout?&#10;A) Older adult&#10;B) Compromised immunity&#10;C) Psychosis&#10;D) Renal failure&#10;E) Cardiac compromise

Accepted Answer

Colchicine must be used with extreme caution in older adults or debilitated patients,patients with impaired renal function,and patients with impaired cardiac function.Colchicine can be used in immunocompromised patients.Patients with psychosis can use colchicine for treatment of gout.

Question 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?&#10;A) It prevents uric acid crystal formation.&#10;B) It promotes uric acid excretion.&#10;C) It provides analgesia.&#10;D) It treats acute gout attacks.

Accepted Answer

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.

Question 3

The nurse is caring for a patient with a new prescription for donepezil (Aricept)for symptoms of mild dementia.Which symptom exhibited by the patient should the nurse report to the physician immediately?

A) Bradycardia
B) Vomiting
C) Diarrhea
D) Dyspepsia

Bradycardia

Accepted Answer

Cholinergic agents cause a slowing of the heart.The health care provider should be notified if the heartbeat is regularly less than 60 beats/min.Vomiting,diarrhea,and dyspepsia are common adverse effects of donepezil (Aricept)and should subside after 2 to 3 weeks of therapy.

Question 4

Which laboratory test result would the nurse observe when a patient has hepatotoxicity?&#10;A) Decreased bilirubin&#10;B) Increased albumin&#10;C) Decreased alkaline phosphatase&#10;D) Increased alanine aminotransferase (ALT)

Accepted Answer

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.

Question 5

A patient recently diagnosed with Alzheimer's disease is placed on memantine (Namenda).The family asks why this medication is given.Which explanation(s) by the nurse is/are accurate?&#10;A) Memantine prevents the neurodegeneration of the disease.&#10;B) Memantine improves word recall.&#10;C) Memantine increases the ability to do tasks.&#10;D) Memantine improves sleep.&#10;E) Memantine increases appetite.

Accepted Answer

Memantine improves cognitive function and behavioral symptoms (word recall,naming objects,language,word finding,and improved ability to do tasks).Memantine does not prevent the neurodegeneration of the disease,improve sleep cycle,or increase appetite.

Question 6

Which nursing action is accurate when administering colchicine?&#10;A) Administer the medication subcutaneously.&#10;B) Maintain fluid intake of at least eight 8-ounce glasses daily.&#10;C) Increase fiber in the diet to prevent constipation.&#10;D) Inform the patient that pain will be alleviated in 2 weeks.

Accepted Answer

Monitor intake and output during therapy.Maintain fluid intake at eight to twelve 8-ounce glasses daily.Colchicine should not be administered subcutaneously.Constipation is not an adverse effect with this medication.Pain will subside in less than 2 weeks.

Question 7

What condition is allopurinol (Zyloprim)used to treat?&#10;A) Gout resulting from antineoplastic therapy&#10;B) Acute attacks of gouty arthritis&#10;C) Cholelithiasis&#10;D) First time gout attacks

Accepted Answer

Allopurinol can be used to treat primary gout or gout resulting from antineoplastic therapy.Allopurinol is not effective in treating acute attacks of gouty arthritis or gallstones and will not relieve a gout attack that has already started.

Question 8

A patient is prescribed memantine (Namenda)10 mg by mouth daily in liquid form.When preparing this medication,the nurse observes that memantine (Namenda)oral solution has 2 mg/mL in 360 mL.How many milliliters will the nurse prepare?

A) 2.5
B) 5
C) 10
D) 15

Accepted Answer

There are 2 mg/mL.The patient needs 10 mg.10 divided by 2 = 5 mL.

Question 9

What is the mechanism of action of memantine (Namenda)?&#10;A) Increases production of dopamine&#10;B) Decreases production of serotonin&#10;C) Blocks N-methyl-D-aspartate (NMDA) receptors in the central nervous system (CNS)&#10;D) Enhances reuptake of central neurotransmitters

Accepted Answer

Although the causes are unknown,one of the neurochemical characteristics of Alzheimer's disease is persistent activation of NMDA receptors in the CNS.Memantine blocks these receptors and is used alone or in combination with an acetylcholinesterase inhibitor in the treatment of moderate to severe Alzheimer's dementia.A diet high in tyrosine,a precursor of dopamine,might increase production of the neurotransmitter.Serotonin production is largely influenced by exercise; increasing exercise stimulates the production of more neurotransmitters.Reuptake of central neurotransmitters,a natural event,may be enhanced by drugs such as selective serotonin reuptake inhibitors.

Question 10

The nurse is caring for a patient diagnosed with gout who has elevated uric acid levels.Which medication will likely be administered?&#10;A) Allopurinol (Zyloprim)&#10;B) Disulfiram (Antabuse)&#10;C) Lactulose (Cephulac)&#10;D) Memantine (Namenda)

Accepted Answer

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.

Question 11

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?&#10;A) Diminished fever&#10;B) Diarrhea or nausea&#10;C) Increased urination&#10;D) Decrease in erythema

Accepted Answer

The answer of The nurse receives an order to administer...

Deck 49: Miscellaneous Agents