NURS 510 Nursing Research Methods

Correct Answer: B) Block reuptake of norepinephrine and/or serotonin

Explanation:

B) Antidepressants commonly work by blocking the reuptake of neurotransmitters, primarily serotonin and norepinephrine, at the presynaptic neuron. This leads to increased concentrations of these neurotransmitters in the synaptic cleft, enhancing neurotransmission and improving mood and emotional regulation.

SSRIs (Selective Serotonin Reuptake Inhibitors) block serotonin reuptake.

SNRIs and tricyclic antidepressants block the reuptake of both serotonin and norepinephrine.

Though mechanisms vary slightly, the shared action is enhancing monoamine availability at synaptic junctions.

Why the other options are incorrect:

A) Increase efficacy of GABA in limbic system and cortex:

This describes the action of benzodiazepines, not antidepressants. GABA is the brain’s main inhibitory neurotransmitter.

C) Antagonize dopamine receptors on postsynaptic membrane:

This is a mechanism used by antipsychotics, not antidepressants. Blocking dopamine can treat psychosis but doesn't address the monoamine deficiency in depression.

D) Antagonize serotonin receptors on postsynaptic membrane:

This would block serotonin's effect, potentially worsening depressive symptoms. Some drugs do target specific serotonin subtypes for unique purposes, but this is not the shared mechanism of all antidepressants.

Correct Answer: C) A 40-year-old male taking glucocorticoids for inflammatory bowel disease

Explanation:

Chronic use of glucocorticoids is a well-established risk factor for osteoporosis. These medications decrease bone formation, increase bone resorption, and reduce calcium absorption, all of which contribute to bone loss. Even relatively short courses of glucocorticoids can impact bone density, and individuals with conditions like inflammatory bowel disease often require long-term treatment, compounding the risk.

A) A 30-year-old male who drinks alcohol occasionally with a BMI of 25:

This individual has no major risk factors for osteoporosis. Occasional alcohol use and a normal BMI do not significantly increase risk.

B) A 22-year-old female who recently had a baby:

While pregnancy causes temporary shifts in calcium demands, young maternal age and hormonal shifts do not typically cause long-term bone loss, especially if nutrition is adequate postpartum.

D) A 35-year-old female who recently began running marathons:

Weight-bearing exercise like running is generally protective against osteoporosis. Unless accompanied by nutritional deficiencies or amenorrhea (e.g., in female athlete triad), her activity is not a risk factor.

Correct Answer: A) Today at 8:30 AM

Explanation:

Insulin Lispro (Humalog) is a rapid-acting insulin. After subcutaneous administration, it:

Begins working in about 15 minutes

Peaks in 1 to 2 hours

Lasts about 3 to 5 hours

A) Today at 8:30 AM is 1 hour after administration, placing the client within the peak action window, when risk for hypoglycemia is highest if food intake is insufficient or delayed.

Why the other options are incorrect:

B) Today at 7:45 AM:

This is only 15 minutes after injection, when insulin action is just beginning. Hypoglycemia is unlikely this early, especially if the client is eating breakfast as planned.

C) Today at 12:30 PM:

This is 5 hours after the dose, when the insulin's effect is tapering off. Hypoglycemia is less likely unless another dose or skipped meal occurs.

D) Tomorrow at 6:30 AM:

There is no relation between today's insulin dose and tomorrow morning. Lispro does not last this long, and there is no lingering hypoglycemic effect expected.

Correct Answer: B) Increased creatinine

Explanation:

Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. When the glomerular filtration rate (GFR) decreases, the kidneys are less effective at filtering creatinine from the blood, leading to elevated serum creatinine levels. This makes increased creatinine a key marker of impaired kidney function.

Why other options are wrong:

A) Decreased BUN:

Blood urea nitrogen (BUN) typically increases, not decreases, with a drop in GFR, as the kidneys become less able to excrete urea.

C) Decreased white blood cell count:

WBC count is not directly related to GFR. It may change due to infection, immune suppression, or bone marrow disorders but is not a marker of kidney filtration.

D) Increased red blood cell count:

Clients with chronic kidney disease often have anemia (low RBC count) due to decreased erythropoietin production by the kidneys. An increase in RBCs is not expected with decreased GFR.

Correct Answer: B) The drug impacts many factors including the natural hormone GLP-1 to increase insulin production.

Explanation:

B) Semaglutide is a GLP-1 receptor agonist, meaning it mimics the action of the natural hormone glucagon-like peptide-1 (GLP-1). It helps manage type 2 diabetes and promotes weight loss by:

Stimulating glucose-dependent insulin secretion

Suppressing glucagon release

Slowing gastric emptying, which promotes satiety and reduces appetite

Reducing food intake, contributing to weight loss

These combined effects help lower blood glucose and promote weight reduction, making it a valuable therapy in T2DM and obesity management.

Why the other options are incorrect:

A) This drug is safe for the client who is pregnant:

Semaglutide is not recommended during pregnancy. There is limited human data, and it is generally discontinued if pregnancy is confirmed.

C) The drug is used for T1DM most of the time:

Semaglutide is not approved for use in Type 1 diabetes, which requires insulin replacement, as T1DM patients lack endogenous insulin production.

D) The blood sugar does not need to be monitored as closely as other medication:

Although semaglutide has a lower risk of causing hypoglycemia (especially when used alone), blood glucose monitoring is still important, especially if used with other agents like sulfonylureas or insulin.

Correct Answer: C) Psychopharmacological medications have similar dosing across all age groups.

Explanation:

C) Psychopharmacological medications have similar dosing across all age groups is not accurate and should not be included in client education. Age significantly affects drug metabolism and clearance, especially in older adults and children. Older adults often require lower doses due to reduced liver and kidney function, altered body composition, and increased sensitivity to drug effects. Children also require carefully adjusted dosages based on age and weight.

Why the other options are correct:

A) Renal disease may impact drug choice and dose in some clients:

Correct. Renal impairment affects drug elimination, requiring dose adjustments to prevent accumulation and toxicity.

B) These medications have the risk for cytochrome P450 interactions that impact the action of the medication:

Correct. Many psych meds are metabolized by liver enzymes, especially the CYP450 system, and may have drug-drug interactions that alter effectiveness or increase side effects.

D) Hepatic disease can impact dose:

Correct. The liver metabolizes most psychotropic drugs. If liver function is impaired, drug levels can accumulate, necessitating dose reductions or alternative medications.

Correct Answer: A) It is used to relieve pain from urinary irritation.

Explanation:

A) Phenazopyridine (Pyridium) is a urinary analgesic used to relieve pain, burning, urgency, and discomfort caused by irritation of the urinary tract, often associated with urinary tract infections (UTIs) or procedures like catheterization. It does not treat the infection itself but provides symptomatic relief.

Why the other options are incorrect:

B) It should be taken with an antibiotic until both medications are gone:

Phenazopyridine is often started with an antibiotic, but it is typically used for short-term relief (usually 2–3 days) because prolonged use may mask worsening symptoms. It is not intended to be taken for the full antibiotic course.

C) It is contraindicated for clients with urinary tract infection to use:

This is false. Phenazopyridine is commonly prescribed to relieve UTI symptoms. It is not contraindicated; in fact, it complements antibiotic therapy for comfort.

D) The drug will relieve discomfort almost immediately:

While relief can be fairly quick, saying it works "almost immediately" is an exaggeration. It generally takes some time after ingestion (usually 30 minutes to an hour) to be effective. Immediate relief is not guaranteed.

Correct Answer: A) "This is normal because it typically takes 3-6 weeks for medications for depression to reach full therapeutic effect."

Explanation:

A) Antidepressants, such as SSRIs, SNRIs, or tricyclics, generally take 3 to 6 weeks to produce noticeable improvement in mood and energy. It is important to educate the client that symptom relief is not immediate and that patience and adherence are key during the early phase of treatment. Some clients may notice early changes in sleep or appetite, but full therapeutic effects take time.

Why the other options are incorrect:

B) "Your symptoms should have improved by now...":

This statement is inaccurate and misleading. It may cause unnecessary concern or mistrust, as 7 days is too early to judge effectiveness.

C) "Clients who do not have symptom relief in 5-7 days usually need to be placed on a different medication.":

This is incorrect. Medication changes are not considered until a full trial period (usually 4–6 weeks) is completed unless side effects are severe.

D) "Any symptoms that remain after 7 days will be permanent.":

This is false and inappropriate. Most depressive symptoms are reversible with proper treatment and time. This response may unnecessarily discourage the client.

Correct Answer: C) Shock

Explanation:

A comminuted fracture involves the bone being broken into three or more fragments, typically caused by high-energy trauma, such as a fall or motor vehicle accident. While it is a serious injury, the presence of shock is not commonly associated with isolated extremity fractures, such as one in the right arm. Shock, which is a systemic condition involving inadequate tissue perfusion, typically results from massive blood loss, severe trauma, or internal injury—scenarios more typical in pelvic fractures, bilateral femur fractures, or polytrauma, not single limb fractures.

Why the other options are more likely:

A) Ecchymosis:

Bruising or discoloration of the skin (ecchymosis) around the site of the fracture is common. It occurs due to bleeding from soft tissue and blood vessels damaged by bone fragments. In comminuted fractures, with multiple sharp bone ends, this is an expected finding.

B) Crepitus:

Crepitus is a hallmark sign of fractures involving unstable bone fragments. In a comminuted fracture, the broken pieces may grind against each other, producing a grating sound or sensation upon palpation or movement. This is commonly noted during physical assessment.

D) Deformity:

Comminuted fractures often result in visible or palpable deformity due to misalignment of multiple bone pieces and disruption of normal anatomical contours. The limb may appear shortened, angulated, or irregular, which is a significant indicator of bone injury.