All of the following are protein bound except:
- A. Propranolol
- B. Atenolol
- C. Phenylbutazone
- D. Warfarin
Correct Answer: B
Rationale: Atenolol has low protein binding; others bind extensively.
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The therapeutic goals when prescribing include(s):
- A. Curative
- B. Palliative
- C. Preventive
- D. All of the above
Correct Answer: D
Rationale: Therapeutic goals can be curative, palliative, or preventive , depending on the patient's condition and needs.
In the presence of pentazocine, a higher concentration of morphine is required to elicit pain relief. Pentazocine by it self has a smaller analgesic effect than does morphine, even at the highest dose, Which of the following is correct regarding these medications?
- A. Pentazocine is a competitive antagonist
- B. Morphine is a full agonist, and pentazocine is a partial agonist
- C. Morphine is less efficacious than is pentazocine
- D. Morphine is less potent than is pentazocine
Correct Answer: B
Rationale: Pentazocine's submaximal effect and antagonism of morphine indicate it is a partial agonist, while morphine is a full agonist.
When involved in phase III drug evaluation studies, what responsibilities would the nurse have?
- A. Working with animals who are given experimental drugs
- B. Choosing appropriate patients to be involved in the drug study
- C. Monitoring and observing patients closely for adverse effects
- D. Conducting research to determine effectiveness of the drug
Correct Answer: C
Rationale: Phase III studies involve use of a drug in a vast clinical population in which patients are asked to record any symptoms they experience while taking the drugs. Nurses may be responsible for helping collect and analyze the information to be shared with the Food and Drug Administration (FDA) but would not conduct research independently because nurses do not prescribe medications. Use of animals in drug testing is done in the preclinical trials. Select patients who are involved in phase II studies to participate in studies where the participants have the disease the drug is intended to treat. These patients are monitored closely for drug action and adverse effects. Phase I studies involve healthy human volunteers who are usually paid for their participation. Nurses may observe for adverse effects and toxicity.
A pharmaceutical lab states that a drug causes negative side effects in 3 of every 100 patients. To confirm this affirmation, another laboratory chooses 5 people at random who have consumed the drug. What is the probability that at least two experience side effects?
- A. 0.8687
- B. 0.1313
- C. 0.00847
- D. 0.0003
Correct Answer: C
Rationale: The probability of at least two experiencing side effects is P(X≥2) = 1 - [P(X=0) + P(X=1)]. Using binomial calculations: P(X=0) = 0.8687, P(X=1) = (5 choose 1) * 0.03 * 0.97^4 = 0.1342, so P(X≥2) = 1 - (0.8687 + 0.1342) = 0.00847, matching the document.
The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied:
- A. Immediately before swimming
- B. 15 minutes before exposure to the sun
- C. Immediately before exposure to the sun
- D. At least 30 minutes before exposure to the sun
Correct Answer: D
Rationale: Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.