A 22-year-old man has taken an overdose of sleeping pills after learning that he did not receive the job he has recently been interviewed for. He is found by his roommate conscious but not able to completely follow commands. The roommate calls the local poison control center. Instructions are given to self-administer syrup of ipecac while waiting for the rescue squad to respond. This agent has a mechanism of action that involves which of the following?

Correct Answer: B

Rationale: Syrup of ipecac induces vomiting in overdose. It stimulates the chemotactic trigger zone in the medulla-prompting emesis. Gag reflex stimulation is secondary. Suppressing pressures , gag reflex , or motor cortex (E) don't apply. Though less used now, ipecac's CNS action expels pills, aiding this acute scenario, distinct from mechanical or suppressive effects.

Correct Answer: C

Rationale: Levetiracetam treats post-stroke focal seizures by modulating SV2A, offering efficacy, minimal hepatic metabolism, and low interaction risk, ideal for an elderly patient with likely polypharmacy. Phenytoin, a sodium channel blocker, controls seizures but has nonlinear kinetics and P450 induction, risking toxicity. Oxcarbazepine, similar to carbamazepine, has hyponatremia risks, concerning in the elderly. Phenobarbital sedates and interacts via P450. Levetiracetam's safety, renal clearance, and effectiveness in stroke-related epilepsy, per guidelines, make it the most appropriate here.

Correct Answer: B

Rationale: Fluticasone, a corticosteroid, is contraindicated with active infections (e.g., viral colds) due to immunosuppression risks . 'My kids have a head cold' suggests exposure, prompting nurse-prescriber collaboration to assess infection status. Licorice , psoriasis , and fruit don't contraindicate use. Choice B prioritizes safety, avoiding exacerbation of undetected infection.

Correct Answer: D

Rationale: The correct answer is D) "Do not make important decisions or operate machinery while taking this drug." This instruction is crucial because Novahistine DM contains codeine, which is an opioid that can cause drowsiness, dizziness, and impair cognitive function. Therefore, it is important for patients to be aware of the potential side effects and avoid activities that require alertness and concentration while taking this medication. Option A) "Drink a full glass of water when taking this medication" is not the most critical instruction for this specific medication. While staying hydrated is important in general, it is not directly related to the specific effects of Novahistine DM. Option B) "Keep this medication at your bedside so you can take it as needed" is not an appropriate instruction as it may lead to overuse or misuse of the medication. It is important for patients to follow the prescribed dosing schedule and not self-medicate. Option C) "Take this drug exactly as indicated" is a good general instruction for all medications; however, in the case of Novahistine DM, the potential side effects of codeine need to be emphasized, making option D more critical. In an educational context, it is essential for nurses to provide comprehensive medication education to patients, including information on proper administration, potential side effects, and safety precautions. Understanding the rationale behind specific instructions can help patients make informed decisions about their medication management and promote safe and effective treatment outcomes.

Correct Answer: B

Rationale: Heparin anticoagulates, monitored by aPTT (therapeutic: 60-80 seconds). An aPTT of 90 seconds indicates over-anticoagulation, risking bleeding, needing immediate action (e.g., stop infusion). Bruising and redness are minor. Platelets of 150,000 are normal. Prolonged aPTT aligns with heparin's effect, critical in therapy where bleeding is a threat, making B the finding requiring swift response.