Nokea
Protein binding of a drug helps in
- A. Distribution
- B. Prolonging half life
- C. Limiting metabolism
- D. All of the above
Correct Answer: D
Rationale: Protein binding affects distribution (bound drugs stay in plasma), prolongs half-life (less free drug available for clearance), and limits metabolism (bound drug is less accessible to enzymes).
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A low-carbohydrate, high-protein diet may:
- A. Increase drug-metabolizing enzymes
- B. Decrease drug absorption from the GI tract
- C. Alter drug binding to plasma proteins
- D. Enhance drug elimination
Correct Answer: A
Rationale: High-protein diets can induce hepatic enzymes (e.g., CYP450), increasing drug metabolism.
A nurse is caring for a client who has increased intracranial pressure and is receiving Mannitol. Which of the following findings should the nurse report to the provider?
- A. Blood glucose 150 mg/dL
- B. Urine output 40 mL/hr
- C. Dyspnea
- D. Bilateral equal pupil size
Correct Answer: C
Rationale: Dyspnea may indicate pulmonary edema, a potential complication of mannitol therapy.
What is the most reliable method to calculate a pediatric patient's medication dosage?
- A. Age
- B. Height
- C. Body surface area (BSA)
- D. Placement on a growth scale
Correct Answer: C
Rationale: The most reliable method is by proportional amount of BSA or body weight. Because of the differences in weight among children, age is not a reliable method. Because of the differences in height among children, this is not a reliable method. Placement on a growth scale identifies how the child corresponds to other children on a percentile. Although it is determined by a specific measurement, the percentile identified would not be a specific measurement; therefore, this is not a reliable method.
Ciprofloxacin otic drops are contraindicated in:
- A. Children
- B. Patients with acute otitis externa
- C. Patients with a perforated tympanic membrane
- D. Swimmer's ear
Correct Answer: C
Rationale: Ciprofloxacin otic risks ototoxicity with perforated eardrums; it's safe in kids or swimmer's ear .
Digoxin is a drug that has been used to treat systolic heart failure for over 200 years. It has a therapeutic index value of 2. How many daily doses of digoxin will the average patient have to take at one time to have a 50:50 chance of developing toxic side effects?
- A. One
- B. Two
- C. I don't know
Correct Answer: B
Rationale: With a therapeutic index of 2, the toxic dose is twice the therapeutic dose. Taking two daily doses at once would reach this threshold, giving a 50:50 chance of toxicity.