Practice Exam 3 based on practice exam 3

What is the first line vasopressor in septic shock

Norepinephrine

Why is norepinephrine first line in septic shock

It causes vasoconstriction and helps maintain mean arterial pressure at 65 mmHg or greater

Which drug is used to treat toxoplasmosis

Pyrimethamine

Which drug is used to treat pinworms

Mebendazole

Which drug is used to treat malaria

Chloroquine

Which drug is used to treat giardiasis

Metronidazole

Which drug is used to treat scabies

Ivermectin

Which drug is used to treat invasive candidiasis

Fluconazole

What antidote is used for acetaminophen overdose

Acetylcysteine

What common side effect should the nurse monitor for with propofol

Hypotension

What is a first line medication for neuropathic pain from herpes zoster

Gabapentin

What infection causes frothy yellow green discharge with vaginal itching and dysuria

Trichomoniasis

What is the first line treatment for trichomoniasis

Metronidazole

What are classic signs of aspirin toxicity

Tinnitus hyperventilation sweating and confusion

How does acetaminophen reduce fever

It inhibits prostaglandin synthesis in the hypothalamus

What infections is metronidazole used to treat

Anaerobic bacterial infections and protozoal infections

What common adverse effects are seen with metronidazole

Nausea vomiting metallic taste and dark urine

What central nervous system effects can metronidazole cause

Headache confusion and seizures

What are common features of acute inflammation

Redness heat swelling vasodilation increased capillary permeability and release of histamine and prostaglandins

What is a major adverse effect of opioid analgesics

Bradypnea

What major risk is associated with celecoxib

Increased risk of cardiovascular events

What testing supports bacterial pneumonia

Sputum testing for Mycoplasma pneumoniae and elevated procalcitonin

What can happen when broad spectrum antibiotics are first given in gram negative sepsis

Endotoxin release can worsen the inflammatory response and hypotension

Why are blood cultures obtained before antibiotics

To identify the causative pathogen and guide antibiotic therapy

What is the role of inflammation in the body

It helps eliminate pathogens and promote tissue repair

How is sepsis best defined

A systemic inflammatory response to infection resulting in organ dysfunction

Why can hypotension persist in septic shock despite fluids and vasopressors

Vascular leakage and endothelial dysfunction cause ineffective fluid distribution

How does norepinephrine work in septic shock

It activates alpha adrenergic receptors causing vasoconstriction and increased blood pressure

What common side effect should patients know about with aspirin

Increased risk of gastrointestinal bleeding

Which antifungal class is the largest and most versatile

Azoles

What is a major adverse effect of amphotericin B

Nephrotoxicity and electrolyte imbalances

What should the nurse monitor closely when giving fluconazole to a patient with liver history

Hepatic function

What is the first step in the one hour sepsis bundle

Measure lactate levels

What findings are consistent with fever caused by inflammation

Tachypnea increased white blood cell count tachycardia and temperature greater than 102 degrees Fahrenheit

What is the first line treatment for syphilis

Penicillin G

A patient with frequent nonsteroidal anti inflammatory drug use has black tarry stools hypotension tachycardia and low hemoglobin what condition is most likely

Peptic ulcer disease

What is the highest safety concern in an opioid naive patient receiving morphine

Respiratory depression

What should be given with isoniazid to prevent peripheral neuropathy

Vitamin B6 or pyridoxine

How do opioids such as morphine relieve severe pain

They act on mu and kappa receptors in the central nervous system to alter pain perception

What conditions are increased in obesity

Type 2 diabetes mellitus osteoarthritis colorectal cancer and cardiovascular disease

Why must high fever in children be treated

It can cause seizures and brain damage and should be kept below 102 degrees Fahrenheit with antipyretics

How do lipase inhibitors work for weight management

They block the absorption of dietary fat in the intestines

What medication reverses opioid induced respiratory depression

Naloxone

What topical medication is commonly used for tinea corporis

Topical clotrimazole

What lab pattern supports bacterial sepsis secondary to pneumonia

Elevated white blood cell count with a shift to the left including bandemia

Which protozoal infections from contaminated water can cause diarrhea cramps nausea fatigue weight loss and dehydration

Amebiasis and cryptosporidiosis

What major adverse effect is associated with succinylcholine

Hyperkalemia

Why must patients with malaria complete the full course of treatment

To fully eradicate the parasite and prevent recurrence

What are common findings in septic shock

Increased heart rate cool clammy skin persistent hypotension despite adequate fluid resuscitation hypoxia and respiratory acidosis

How does succinylcholine cause paralysis

It stimulates postsynaptic acetylcholine receptors and depolarizes the motor end plate of skeletal muscle

How is fever initiated

The hypothalamus is reset to a higher temperature in response to pyrogens

What type of local anesthetic is lidocaine and how does it work

It is an amide sodium channel blocker that prevents nerve impulse transmission

What is trichomoniasis

It is a protozoan sexually transmitted infection treated with metronidazole

Which patients have high risk factors for tuberculosis

A patient with human immunodeficiency virus a person who injects drugs and lives in a crowded shelter and a recent traveler to a tuberculosis endemic country

What drug treats malignant hyperthermia

Dantrolene

How does dantrolene work

It inhibits calcium release from the sarcoplasmic reticulum

What lab value should be monitored with nonsteroidal anti inflammatory drug therapy

Serum creatinine

Why are multiple drugs needed for active tuberculosis

To reduce the chance that bacteria become resistant

What is the purpose of pyridoxine with isoniazid

It reduces the risk of peripheral neuropathy

How are selective cyclooxygenase 2 inhibitors different from nonselective nonsteroidal anti inflammatory drugs

They reduce gastrointestinal irritation and ulcer risk

What mechanism decreases perfusion in septic shock

Vasodilation and vascular leakage causing ineffective fluid distribution

What important risk is associated with tramadol

It can cause serotonin syndrome with selective serotonin reuptake inhibitors or monoamine oxidase inhibitors and can lower the seizure threshold

What symptoms and findings are common in malaria

Fever chills headache profuse sweating tachypnea and splenomegaly

What complications should be monitored with long term corticosteroid therapy

Hyperglycemia osteoporosis and delayed wound healing

What medication should be immediately available when there is a family history of malignant hyperthermia

Dantrolene sodium

Why does aspirin increase bleeding risk

It inhibits platelet aggregation

What medications are included in first line tuberculosis treatment

Rifampin isoniazid ethambutol and pyrazinamide

A patient has a painless genital chancre and lymphadenopathy after unprotected sex what infection and treatment fit best

Syphilis treated with penicillin

What adverse effect requires close monitoring with amphotericin B

Nephrotoxicity