A female patient is questioning the nurse on why she can’t explain the same 5-day antibiotic (Zithromax) that her husband received. The patient is 65 with a history of and has an abnormal heart rhythm. The nurse explains that:

Zithromax can cause cancer in women.

Your medical conditions, age, and gender make you susceptible to QT prolongation, a known risk of this antibiotic.

This antibiotic is less effective in women.

Zithromax is expensive, so your insurance won’t pay for it.

Answer and Explanation

The Correct Answer is B

Choice A reason is that Zithromax (azithromycin) is not linked to cancer in women; this is inaccurate. QT prolongation is a known risk, especially in elderly patients with cardiac issues, so this is incorrect.

Choice B reason: Azithromycin can prolong the QT interval, risking arrhythmias, particularly in older women with heart rhythm issues. This explains the different prescribing, making it the correct choice.

Choice C reason: Zithromax’s effectiveness is not gender-specific; efficacy depends on the infection, not sex. The cardiac risk is the concern, so this is incorrect for the explanation.

Choice D reason: Cost or insurance is irrelevant to the medical decision. QT prolongation risk in this patient’s profile drives the choice, so this is incorrect.

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Correct Answer is A

Explanation

Choice A reason: Morphine, an opioid, binds to mu, kappa, and delta receptors in the brain, spinal cord, and gastrointestinal tract. Mu receptors in the gut slow peristalsis, causing constipation, while central receptors relieve pain. This multi-receptor binding explains both therapeutic and side effects, making this the correct choice.

Choice B reason: Constipation from morphine occurs at therapeutic, not just toxic, doses due to mu receptor activation in the gastrointestinal tract, which reduces motility. Toxicity may worsen side effects, but constipation is a common effect at standard doses, making this choice inaccurate for explaining morphine’s mechanism.

Choice C reason: Morphine’s receptors (e.g., mu) regulate multiple processes, but the drug itself isn’t selective to multifunctional receptors. It binds broadly to opioid receptors, causing both analgesia and side effects like constipation. This choice misrepresents morphine’s non-selective binding, making it less accurate than choice A.

Choice D reason: Morphine’s effects, including analgesia and constipation, result from specific receptor binding, not coincidental processes. It activates opioid receptors in the brain for pain relief and in the gut for reduced motility. This choice incorrectly suggests constipation is unrelated to morphine’s pharmacological action, making it incorrect.

A. Captopril PO B. Hydralazine (Apresoline) 25 mg PO C. Minoxidil 20 mg PO D. Sodium nitroprusside (Nitropress) IV

Correct Answer is D

Explanation

Choice A reason: Captopril PO is used for chronic hypertension, not acute crises, due to slower onset. IV nitroprusside acts rapidly to control severe hypertension, so this is incorrect.

Choice B reason: Hydralazine PO has a slower onset, unsuitable for hypertensive crisis requiring immediate control. IV nitroprusside is faster and titratable, making this incorrect for acute management.

Choice C reason: Minoxidil PO is for refractory hypertension, not emergencies, due to delayed action. Sodium nitroprusside IV is preferred for rapid control, so this is incorrect.

Choice D reason: Sodium nitroprusside IV is the drug of choice for hypertensive crisis, offering rapid, titratable blood pressure reduction. This aligns with urgent needs, making it the correct choice.

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A female patient is questioning the nurse on why she can’t explain the same 5-day antibiotic (Zithromax) that her husband received. The patient is 65 with a history of and has an abnormal heart rhythm. The nurse explains that:

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Naxlex Comprehensive Predictor Exams

A patient who is taking morphine for pain asks the nurse how a pain medication can also cause constipation. What does the nurse know about morphine?

Correct Answer is A

Explanation

A patient is admitted with severe hypertensive crisis. The nurse will anticipate administering which medication?

Correct Answer is D

Explanation

When administering a central nervous system depressant, the nurse should closely observe for drug toxicity in which patient?

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