Nokea
A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient?
- A. Noncompliance: Cost of the drug
- B. Deficient knowledge: Unfamiliar with drug therapy
- C. Risk for injury: Related to adverse effects of the drug
- D. Ineffective health maintenance: Need for medication
Correct Answer: C
Rationale: Sedation increases the risk of falls or injury, making 'Risk for injury' the priority diagnosis over knowledge deficits or compliance issues.
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The patient has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a (Rebif). The patient takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per injection. If the patient takes an injection on Monday, how much of the drug would still be in the patient's system when she takes her next injection on Wednesday, assuming the half-life of the drug is 24 hours?
- A. 22 mcg
- B. 16.5 mcg
- C. 11 mcg
- D. 5.5 mcg
Correct Answer: C
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to 1 half the peak level it previously achieved. On Tuesday, there would be 22 mcg remaining in the body, so option A is incorrect. On Wednesday 11 mcg would remain, so option C is the correct answer. At 12 hours before taking the next dose on Wednesday, there would be 16.5 mcg remaining. If the injection were not taken on Wednesday, 12 hours after the dose was due, there would be 5.5 mcg remaining.
In which type of cell are ligand-gated ion channels most commonly found?
- A. Cells that are terminally differentiated
- B. Cells that produce large proteins
- C. Cells that need to respond quickly to external stimuli
- D. Cells that respond to mechanic forces
Correct Answer: C
Rationale: Ligand-gated ion channels enable rapid responses to stimuli, common in excitable cells like neurons and muscle cells.
Which of the following is seen in first order kinetics
- A. Rate depends upon plasma cone.
- B. Rate does not depend on plasma cone.
- C. Rate depends upon plasma protein binding
- D. Elimination depends upon amount of drug
Correct Answer: A
Rationale: In first-order kinetics, the elimination rate is proportional to plasma concentration.
A patient with Cushing's syndrome is being treated by X-irradiation of the pituitary. It may take several months of treatment for adequate symptomatic and metabolic improvement. Until that time, which of the following might be administered adjunctively to suppress glucocorticoid synthesis?
- A. Cimetidine
- B. Cortisol (massive doses)
- C. Fludrocortisone
- D. Ketoconazole
Correct Answer: D
Rationale: Ketoconazole inhibits adrenal steroidogenesis, reducing glucocorticoid levels in Cushing's syndrome.
Which of the following statements about pancreatic enzymes is true?
- A. Dosing may be titrated according to the decrease of steatorrhea
- B. The amount of carbohydrates in the meal drives the amount of enzyme used
- C. The amount of medication used is increased with a cystic fibrosis pulmonary flare
- D. The FDA and Internet-available formulations are bioequivalent
Correct Answer: A
Rationale: Pancreatic enzyme dosing adjusts based on steatorrhea reduction; carbs aren't the driver, and flares don't increase it.