Nokea
59 old year female hospitalized in emergency department with confusion and breathlessness. Physical examination reveals: tachycardia, tachypnea and disorientation. Patient has diabetes type 2 and remember that she has taken a drug in the morning. Which of the following can cause the above mentioned symptoms:
- A. Acarbose
- B. Glipizide
- C. Glucagon
- D. Metformin
Correct Answer: B
Rationale: Glipizide can cause hypoglycemia leading to confusion, tachycardia, and breathlessness, especially if taken without food.
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A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions?
- A. Remove the prior dose before applying a new dose.
- B. Rub the ointment directly into your skin until it is no longer visible.
- C. Cover the applied ointment with a clean gauze pad.
- D. Apply the ointment to the same skin area each time.
Correct Answer: A
Rationale: Removing the prior dose prevents overdose and ensures accurate dosing.
What is the mechanism of action of miglitol?
- A. Decreased glucagon release
- B. Increased insulin release
- C. Increased insulin sensitivity in peripheral tissues
- D. Inhibits intestinal brush border enzymes
Correct Answer: D
Rationale: Miglitol inhibits intestinal brush border enzymes, slowing carbohydrate digestion and absorption.
Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?
- A. Tinnitus
- B. Diarrhea
- C. Constipation
- D. Decreased respirations
Correct Answer: A
Rationale: Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism.
A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy Category B drug. What would the nurse inform the patient?
- A. Adequate studies in pregnant women have demonstrated there is no risk to the fetus.
- B. Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women.
- C. Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant women.
- D. There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks.
Correct Answer: B
Rationale: Category B indicates that animal studies have not demonstrated a risk to the fetus. However, there have not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of pregnancy and no evidence of risk in later trimesters. Category A indicates that adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters. Category C indicates that animal studies have shown an adverse effect on the fetus, but no adequate studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the use of the drugs in pregnant women may outweigh potential risks.
Zero order kinetics are seen in all except
- A. Salicylate
- B. Atenolol
- C. Barbiturates
- D. Ethanol
Correct Answer: C
Rationale: Barbiturates typically follow first-order kinetics; others exhibit zero-order at high doses.