I'm going to guess many would be in agreement with this request: tell us what *you* believe are the answers to the questions, or offer at least a thought process and show us what's coming across your mind. You see, I don't even know what drugs you feel will be appropriate for the first case's reaction, so is kinda hard to help you with the questions you're having problems with unless we simply hand out the answers. For example, in case #1, is the patient having just a reaction, or are we looking at something a little more emergent that requires another couple of medication options to consider?
The study questions may seem a little off, but personally I can see the benefit in their off-the-wallness
. Well, except for the coworker sampling the bee pollen... Wha
??? :icon_roll Lol!
Back to it: In the first case study, the newly-emerged left-my-common-sense-at-the-door-patient-#2
is not just some person who was dumped at the ED, but is a fellow coworker. Are you going to treat her any differently? Is your answer to numbers 6 going to change for her simply because she is a nurse, versus Joe-patient who welds steel six stories up and has bills to pay? How about #8? Is her driving ability unaffected simply because of the RN after her name?
I think many of us are guilty of thinking about (subconsciously) treating our coworkers differently, and assume they have supernatural powers no other patient possesses. We are wrong if we follow those thoughts.
And with #2... you may find yourself being asked to do something kind of out of the ordinary. Are you? Play the devil's advocate as ask yourself: Why can't this patient give his own intramuscular shot for this medication? Look at diabetics. They give themselves subcutaneous shots several times a day. A number of them have glucagon emergency kits for their family to use (IM shot) in case their blood glucose plummets. How about those with allergic reactions and Epi-pens... again, an IM shot.
My advice would be to research the particular medication in question, and look at the indications, contraindications, possible adverse reactions, and so on. Consider the patient's condition and think about what could happen, and it could help with your rationale on that particular case.
I don't think a lack of clinical skills will be a problem for each of these cases. Rely on your books, with particular attention paid to the medical diagnosis you suspect (case #1 in particular), the medications you feel are appropriate and why, gain an understanding of each medication and what to watch for, and then consider what is going to be occurring with your patient (physiologically) after treatment and resolution. Use common sense; the off-the-wallness
of the cases is addressing common sense and what you should do, versus what might "feel it's okay" to do based on subconscious misconceptions.
Hang in there! It'll all be as clear as mud soon enough, lol!