Nokea
A 75-year-old woman with diabetes is taking an oral antidiabetic drug. One day she goes without eating for 18 \mathrm{~h}. Her serum glucose concentration is 48 \mathrm{mg} / \mathrm{dL} (hypoglycemic) upon arrival at the emergency department, where she is deemed to be in critical condition. Which of the following drugs most likely aggravated this fasting hypoglycemia?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: B
Rationale: Glyburide, a sulfonylurea, can cause severe hypoglycemia, especially during fasting, due to prolonged insulin release.
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When involved in phase III drug evaluation studies, what responsibilities would the nurse have?
- A. Working with animals who are given experimental drugs
- B. Choosing appropriate patients to be involved in the drug study
- C. Monitoring and observing patients closely for adverse effects
- D. Conducting research to determine effectiveness of the drug
Correct Answer: C
Rationale: Phase III studies involve use of a drug in a vast clinical population in which patients are asked to record any symptoms they experience while taking the drugs. Nurses may be responsible for helping collect and analyze the information to be shared with the Food and Drug Administration (FDA) but would not conduct research independently because nurses do not prescribe medications. Use of animals in drug testing is done in the preclinical trials. Select patients who are involved in phase II studies to participate in studies where the participants have the disease the drug is intended to treat. These patients are monitored closely for drug action and adverse effects. Phase I studies involve healthy human volunteers who are usually paid for their participation. Nurses may observe for adverse effects and toxicity.
Which of the following causes rise in systolic as well as diastolic BP for prolonged period:
- A. Ephedrine
- B. Epinephrine
- C. Dopamine
- D. Norepinephrine
Correct Answer: D
Rationale: Norepinephrine increases both systolic and diastolic BP with prolonged effect.
A nursing instructor is observing a nursing student prepare an oral drug for administration. The instructor determines that the student is performing the procedure correctly when the student compares the label of the drug with the MAR how many times?
- A. 2
- B. 3
- C. 4
- D. 5
Correct Answer: B
Rationale: The proper procedure is to compare the drug label with the MAR three times: when the drug is taken from its storage area, immediately before removing the drug from the container, and before administering the drug to the patient.
Sarah developed a rash after using a topical medication. This is a type __ allergic drug reaction.
- A. I
- B. II
- C. III
- D. IV
Correct Answer: D
Rationale: A rash from topical medication is a Type IV (delayed hypersensitivity) reaction , typically contact dermatitis, not immediate (I), cytotoxic (II), or immune complex (III).
A 7-year-old male fell off a wood pile while playing. He has been admitted to the ICU with multiple broken bones and internal bleeding. What should the nurse know about drug therapy in this type of patient?
- A. Adverse effects may be decreased
- B. Therapeutic effects may be increased
- C. Pharmacodynamics may be altered
- D. Pharmacokinetics remain the same
Correct Answer: C
Rationale: Trauma alters pharmacodynamics (drug effects) due to physiological stress and injury responses.