Nokea
A 57-year-old man was recently diagnosed with Type-2 diabetes mellitus and placed on a medication. He began having myalgias and feeling sick and later developed respiratory distress, so he went to the hospital. His pH was 7.2, and he had elevated blood lactate levels. Which drug is likely causing his problem?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin is associated with lactic acidosis, presenting with low pH and high lactate, especially in overdose or renal impairment.
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A patient with anxiety and depression may respond to:
- A. Duloxetine (Cymbalta)
- B. Fluoxetine (Prozac)
- C. Oxazepam (Serax)
- D. Buspirone (Buspar) and an SSRI combined
Correct Answer: D
Rationale: Buspirone (anxiolytic) with an SSRI addresses both anxiety and depression effectively.
A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client?
- A. Cardiovascular
- B. Immune
- C. Central nervous
- D. Gastrointestinal
Correct Answer: C
Rationale: Extrapyramidal effects are movement disorders caused by medications affecting the central nervous system , like antipsychotics.
The following drug may be used to relieve bladder spasm after urologic surgery:
- A. Atropine
- B. Dicyclomine
- C. Glycopyrrolate
- D. Oxybutynin
Correct Answer: D
Rationale: Oxybutynin, an antimuscarinic, reduces bladder spasms.
What medication is most likely to cause his weight gain?
- A. Acarbose
- B. Exenatide
- C. Glyburide
- D. Pioglitazone
Correct Answer: D
Rationale: Pioglitazone is most likely to cause weight gain due to fluid retention and fat accumulation.
Which of the following regarding E max is correct?
- A. E max assumes that as long as you increase the concentration of the drug, there will be a higher effect of the drug
- B. E max is used to compare the potency of different drugs
- C. E max assumes that all receptors are occupied by the drug and no increase in response is observed if a higher concentration of drug is obtained
- D. All of the previous points are incorrect
Correct Answer: C
Rationale: Emax is the maximal effect when all receptors are occupied; further dose increases yield no additional effect.