Common Test

Question 1

rationale for administering IV NACL

Answer 1

to restore circulating volume and to replace volume loss to increase tissue perfusion levels to the kidneys

Question 2

rationale for administering IV Calcium Gluconate

Answer 2

Regulates action potential threshold thus preventing cardiac toxicity

Question 3

rationale for administering actrapid with dextrose

Answer 3

insulin shifts potassium into the cells while dextrose is given to prevent hypoglycaemia

Question 4

rationale for administering IV sodium bicarbonate

Answer 4

Drug dissociated to provide bicarbonate ion, which neutralizes hydrogen ion concentration and raises blood and urinary pH to correct acidosis/ shifts extracellular potassium into the cells

Question 5

rationale for monitor vital signs including HR, Bp, RR, and Sp02 (os ordered)

Answer 5

Establish baseline data and monitor for decreasing BP and HR which indicates a decrease in circulating blood volume

Question 6

rationale for monitor HR and rhythm continuously

Answer 6

Potassium excess depresses myocardial
conduction.

Decreasing HR can indicate
bradycardia which can progress to cardiac
fibrillation and arrest.

Question 7

rationale for monitor serum potassium level closely

Answer 7

To monitor for normalisation of serum potassium
levels which indicates the effectiveness of
treatment.

Question 8

rationale for monitor for i/o strictly and take note of fluid balance

Answer 8

fluid replacement needs are based on the correction of current deficits and ongoing losses

Question 9

Adverse effect of sodium bicarbonate (alkalinising agent)

Answer 9

metabolic alkalosis
fluid overload
extravasation
hypokalaemia

Question 10

Adverse effect of calcium gluconate/chloride (electrolytes)

Answer 10

hypercalcemia

extravasation

Question 11

Adverse effect of insulin and dextrose

Answer 11

hypokalaemia/ delayed hypoglycaemia

Question 12

Rationale for monitor-ing for signs of hypokalaemia such as muscle weakness and fatigue, muscle cramps and pains and cardiac dysrhythmia

Answer 12

These symptoms may be indicative of hypokalemia. Inform the doctor to review the patient.

Question 13

Rationale for monitor blood glucose levels closely

Answer 13

To monitor for the adverse effects of hypoglycaemia and hyperglycaemia due to the effects of insulin and dextrose 50%

Question 14

Rationale for Monitor for signs of hypercalcemia, such as
weakness, confusion, fatigue, headache, nausea
and vomiting, and constipation

Answer 14

These are symptoms of hypercalcemia. Inform the

doctor to review the drug dose

Question 15

Rationale for Administer bolus slowly not exceeding 200

mg/min, unless in an emergency situation.

Answer 15

Rapid administration of calcium injection may
result in vasodilation, hypotension, bradycardia
and arrhythmia, syncope and cardiac arrest

Question 16

Rationale for Monitor the intravenous site for extravasation.

Answer 16

The drug causes irritation at the site of
infusion/injection. Inform doctor and administer
appropriate antidote (hyaluronidase / sodium
thiosulfate) if needed

Question 17

rationale Monitor for signs of hypokalemia such
as muscle weakness and fatigue, muscle
cramps and pains and cardiac
dysrhythmias.

Answer 17

These symptoms may be indicative of
hypokalemia. Inform the doctor to review
the patient.

Question 18

Monitor for signs of fluid overload such
as shortness of breath, excessive weight
gain or swelling of arms or legs ( 1, any 1
example)

Answer 18

The sodium content may predispose the
patient to fluid overload, especially those
with heart, renal and hepatic failure. Inform
doctor to review the drug

Question 19

Monitor arterial blood gas before and

during treatment

Answer 19

To determine the patient’s response to
therapy and to minimize the possibility of
over dosage and resultant metabolic
alkalosis

Question 20

Monitor intravenous site for
extravasationDrug cause irritation at the
infusion/injection site.

Answer 20

Inform doctor and
administer appropriate antidote
(hyaluronidase) if needed

Question 21

Rationale for Administer IV Pantoprazole
80mg BD stat, followed by 8
mg/hr

Answer 21

To bind irreversibly (inhibit) to the
proton pump in the gastric parietal
cells resulting in reduced gastric
acid secretion.

Question 22

Administer IV Packed Cells 1

pint over 4 hours stat (1)

Answer 22

To replace blood loss

Question 23

Monitor vital signs hourly
including heart rate, respiratory
rate, blood pressure,
temperature and SpO2 (PUD)

Answer 23

To establish baseline data and
monitor for disease progress.
Tachycardia and hypotension
may indicate the development
of hypovolemic shock.

Question 24

To prepare for urgent

Oesophago-Gastro-Duodenoscopy (OGD)

Answer 24

To identify the source of bleeding

and to achieve haemostasis.

Question 25

Pharm class magnesium trisilicate

Answer 25

antacids

Question 26

Pharm goals of magnesium trisilicate

Answer 26

To provide immediate relief of symptoms

Question 27

Pharm class of pantropazole

Answer 27

Proton pump inhibitor

Question 28

Pharm goals of pantropazole

Answer 28

to promote healing of the ulcer

Question 29

pharm goals of amoxicillin/ clarithromycin

Answer 29

To prevent further reoccurrence

of the disease

Question 30

Pharm class of amoxicillin

Answer 30

penicillin

Question 31

Pharm class of clarithromycin

Answer 31

macrolides

Question 32

why does pt need to complete all of his pantroprazole and atibiotics?

Answer 32

The whole course of antibiotics (Amoxicillin and Clarithromycin) should be completed
to maintain therapeutic range and effectiveness of antibiotics (1). Prematurely
stopping antibiotic therapy allows some pathogens to survive, thus promoting the
development of resistant strains (1).

As healing of peptic ulcer takes 6-8 weeks (1) , pantoprazole is given to reduce
gastric acid secretion and allow the healing of the peptic ulcer to take
place (1).

Question 33

rationale Administer IV Omeprazole 40mg BD

stat and OM

Answer 33

To bind irreversibly to proton pump in the gastric

parietal cells resulting in reduced gastric acid secretion.

Question 34

rationale Administer IV Octreotide 50mcg stat

followed by 50 mcg/hr

Answer 34

To decrease hepatic venous pressure

Question 35

Administer IV Ofloxacin 200 mg BD

Answer 35

Inhibit DNA synthesis and prevents bacterial infection

and re-bleeding.