A patient with Cushing's syndrome is being treated by X-irradiation of the pituitary. It may take several months of treatment for adequate symptomatic and metabolic improvement. Until that time, which of the following might be administered adjunctively to suppress glucocorticoid synthesis?
- A. Cimetidine
- B. Cortisol (massive doses)
- C. Fludrocortisone
- D. Ketoconazole
Correct Answer: D
Rationale: Ketoconazole inhibits adrenal steroidogenesis, reducing glucocorticoid levels in Cushing's syndrome.
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You are caring for a patient who takes several drugs. You know that those patients most likely to have adverse drug reactions are who?
- A. Patients with coronary artery disease
- B. Non-compliant patients
- C. Patients who are on the recommended dose
- D. Very young and very old patients
Correct Answer: D
Rationale: Very young and old patients have immature or declining organ function, increasing adverse reaction risk.
The type of adverse drug reaction that is idiosyncratic when a drug given in the usual therapeutic doses is type:
- A. A
- B. B
- C. C
- D. D
Correct Answer: B
Rationale: Type B reactions are idiosyncratic, unpredictable responses to normal doses, unlike dose-related Type A or chronic Type C/D.
A nurse is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The nurse should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?
- A. Bursitis
- B. Brussels
- C. Depression
- D. Glaucoma
Correct Answer: D
Rationale: Oxybutynin is contraindicated in glaucoma due to its anticholinergic effects increasing intraocular pressure.
The adverse events of biguanides are:
- A. Alkalosis
- B. Hypoxemia/acidosis
- C. Weight loss
- D. Anemia
Correct Answer: B
Rationale: Biguanides like metformin can cause lactic acidosis, a serious adverse effect related to impaired mitochondrial function.
Paracetamol is an NSAID with a comparatively low anti-inflammatory effect compared to other NSAIDs.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Paracetamol (acetaminophen) has minimal anti-inflammatory activity, primarily acting as an analgesic and antipyretic.