Nokea
A 44-year-old woman with systemic lupus erythematosus presents to her primary care physician for follow-up. She is currently being managed with an oral glucocorticoid agent. The most likely mechanism of action of this medication involves which of the following?
- A. Inhibition of erythrocytes
- B. Inhibition of macrophages
- C. Stimulation of cyclooxygenase 2 synthesis
- D. Stimulation of phospholipase A2
Correct Answer: B
Rationale: Glucocorticoids inhibit macrophages and other immune cells, reducing inflammation in conditions like lupus.
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An order is written for oxazepam for a 6-year-old child. The nurse notices that there is no established dosage for children 6 to 12 years of age. Knowing that the usual adult dose is 10 mg t.i.d., what would the nurse calculate the appropriate dose to be?
- A. 0.03 mg t.i.d.
- B. 0.3 mg t.i.d.
- C. 1.8 mg t.i.d.
- D. 3.3 mg t.i.d.
Correct Answer: D
Rationale: Because the nurse only knows the child's age, the nurse would need to use Young's Rule to determine the appropriate dosage. Use the formula, child's dose equals the age of the child in years divided by the child's age plus 12 times the average adult dose to calculate the answer. Dose = (6/[6+12]) 10 mg (6/18 = 0.33 10 = 3.3).
Drug of choice in motion sickness is
- A. Metoclopramide
- B. Transdermal scopalamine
- C. Diphenhydramine
- D. Chlorpromazine
Correct Answer: B
Rationale: Transdermal scopolamine is the drug of choice for motion sickness.
A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?
- A. Obtain a blood specimen immediately prior to administering the next dose of medication.
- B. Verify that the client has been taking the medication for 24 hour before obtaining a blood specimen.
- C. Ask the client to provide a urine specimen after the next dose of medication.
- D. Administer the medication, and obtain a blood specimen 30 min late
Correct Answer: A
Rationale: Trough levels are measured just before the next dose to assess the lowest drug concentration in the blood.
A nurse is caring for a hospitalized client who is receiving IV heparin for a deep-vein thrombosis. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?
- A. Vitamin k1
- B. Atropine
- C. Protamine
- D. Calcium gluconate
Correct Answer: C
Rationale: Protamine reverses heparin's anticoagulant effect in bleeding emergencies.
Which of the following is a representative of sulfonylurea?
- A. Metformin
- B. Sitagliptine
- C. Acarbose
- D. Chlorpropamide
Correct Answer: D
Rationale: Chlorpropamide is a sulfonylurea that stimulates insulin release from pancreatic beta cells.