Nokea
A 60-year-old man with Type 2 diabetes mellitus is treated with pioglitazone. Which of the following phrases summarizes best this drug's main mechanism of action?
- A. Blocks intestinal carbohydrate absorption
- B. Causes glycosuria (increased renal glucose excretion)
- C. Increases hepatic gluconeogenesis
- D. Increases target tissue sensitivity to insulin
Correct Answer: D
Rationale: Pioglitazone enhances insulin sensitivity in target tissues like muscle and fat via PPAR-gamma activation.
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Which of the following create a higher risk for digoxin toxicity? Both the cause and the reason for it must be correct.
- A. Older adults because of reduced renal function
- B. Administration of aldosterone antagonist diuretics because of decreased potassium levels
- C. Taking an antacid for gastroesophageal reflux disease because it increases the absorption of digoxin
- D. Doses between 0.25 and 0.5 mg/day
Correct Answer: A
Rationale: Older adults have reduced renal clearance, increasing digoxin toxicity risk.
Which of the following drugs is NOT an aminoglycoside?
- A. Streptomycin
- B. Neomycin
- C. Amikacin
- D. Azithromycin
Correct Answer: D
Rationale: Azithromycin is a macrolide antibiotic, not an aminoglycoside, unlike the others listed.
The patient is taking low dose aspirin daily for his heart. The nurse knows only a portion of the medication taken actually reaches the tissue due to what process?
- A. Distribution
- B. First-pass effect
- C. Reduced absorption
- D. Gastrointestinal circulation
Correct Answer: B
Rationale: Drugs that are taken orally are usually absorbed from the small intestine directly into the portal venous system and then delivers these absorbed molecules into the liver, which immediately break the drug into metabolites, some of which are active and cause effects in the body, and some of which are deactivated and can be readily excreted from the body. As a result, a large percentage of the oral dose is destroyed at this point and never reaches the tissues. This process is not caused by distribution, absorption, or gastrointestinal circulation.
A nurse is providing instructions to a female client who has a new prescription for Zolpidem. Which of the following instructions should the nurse include?
- A. Notify the provider if you plan to become pregnant.
- B. Take the medication 1 hr before you plan to go to sleep.
- C. Allow at least 6 hr for sleep when taking zolpidem.
- D. To increase the effectiveness of zolpidem, take it with a bedtime snack.
Correct Answer: A
Rationale: Pregnancy notification is key due to zolpidem's risks; it's taken just before sleep, needing 7-8 hours.
Both men and women experience bone loss with aging. The bones most likely to demonstrate significant loss are:
- A. Cortical bones
- B. Femoral neck bones
- C. Cervical vertebrae
- D. Pelvic bones
Correct Answer: B
Rationale: Femoral neck is a trabecular bone site prone to significant age-related loss, unlike cortical or other areas .