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The choice of diuretic to use in treating hypertension is based on:
- A. Presence of diabetes with loop diuretics being used for these patients
- B. Level of kidney function with a thiazide diuretic being used for an estimated glomerular filtration rate higher than the mid-40 mL/min range
- C. Ethnicity with aldosterone antagonists best for African Americans and older adults
- D. Presence of hyperlipidemia with higher doses needed for patients with LDL above 130 mg/dL
Correct Answer: B
Rationale: Thiazides are effective with GFR >40-50 mL/min; loops are used for lower GFR.
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Which of the following drugs used to treat Alzheimer's disease is not an anticholinergic?
- A. Donepezil
- B. Memantine
- C. Rivastigmine
- D. Galantamine
Correct Answer: B
Rationale: Memantine is an NMDA receptor antagonist, not an anticholinesterase like the others.
Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her:
- A. To not abruptly discontinue levetiracetam due to risk for withdrawal seizures
- B. To wear sunscreen due to photosensitivity from levetiracetam
- C. To get an annual eye exam while on levetiracetam
- D. To report weight loss if it occurs
Correct Answer: A
Rationale: Abrupt discontinuation of levetiracetam risks withdrawal seizures.
A patient comes to the ER having his quadriceps muscle constantly contracted, you should give him:
- A. Norepinephrine to stimulate the sympathetic nervous system
- B. An antagonist for Norepinephrine
- C. Agonist for acetylcholine
- D. Both B and C
Correct Answer: D
Rationale: Both B and C are correct: a norepinephrine antagonist (e.g., beta-blocker) or acetylcholine agonist (e.g., to relax via parasympathetic action) could relieve muscle contraction.
A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.)
- A. 200
- B. 180
- C. 250
- D. 500
Correct Answer: A
Rationale: Calculation: (100 mL / 30 min) 60 min/hr = 200 mL/hr, matching the provided answer.
The patient asks the nurse why generic drugs would be used and voices concerns that only the brand name product will be safe. What is the nurses best response?
- A. Generic drugs are often less expensive.
- B. Some quality control problems have been found with generic drugs.
- C. Most generic drugs are very safe and can be cost effective as well.
- D. Although initial cost is higher for a brand name it may cost less in the long run.
Correct Answer: C
Rationale: Most generic medications are completely safe and may be identical to the brand name drug except generic medications are often less expensive, but this does not address the patients concern about safety. Although some quality control issues have occurred in the past, this does not address the patients concerns regarding safety or explain why generic drugs are prescribed and used. Although some doctors believe initial cost is higher but will cost less over time, this response also does not address the patients concerns.