A classic drug interaction resulting in an increased bleeding time, involves warfarin and:
- A. Vitamin B6
- B. Aspirin
- C. Folic acid
- D. Rifampin
Correct Answer: B
Rationale: Aspirin inhibits platelet aggregation, enhancing warfarin's anticoagulant effect and increasing bleeding risk.
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A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is thinking about taking St. John's wort but wants to know if it is safe first. The nurse begins by questioning what other medications the patient takes and would be concerned about a drug-alternative drug interaction if the patient is also taking what type of medication?
- A. Antihistamines
- B. Analgesics
- C. Antibiotics
- D. Oral contraceptives
Correct Answer: D
Rationale: St. John's wort can interact with oral contraceptives that alter drug metabolism, which can decrease the effectiveness of the contraceptive. Analgesics, antibiotics, and antihistamines can be taken in combination with St. John's wort without known adverse effects.
Oral rehydration solution has been employed in following EXCEPT:
- A. Severe vomiting
- B. Burn cases
- C. Heat stroke
- D. Diarrhoea
Correct Answer: A
Rationale: Oral rehydration solution (ORS) is used in diarrhea, burns, and heat stroke to replace fluids and electrolytes, but severe vomiting limits its effectiveness due to inability to retain it.
Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
- A. OTC drugs are safe and do not cause adverse effects if taken properly.
- B. OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).
- C. OTC drugs are different from any drugs available by prescription and cost less.
- D. OTC drugs could cause serious harm if not taken according to directions.
Correct Answer: D
Rationale: It is important to follow package directions because OTCs are medications that can cause serious harm if not taken properly. OTCs are drugs that have been determined to be safe when taken as directed; however, all drugs can produce adverse effects even when taken properly. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC education should always be included as a part of the hospital discharge instructions.
The mean weight of 500 college students is 70 kg and the standard deviation is 3 kg. Assuming that the weight is normally distributed, determine how many students weigh exactly 64 kg.
- B. 5
- C. 10
- D. 15
Correct Answer: A
Rationale: In a continuous normal distribution, the probability of an exact value (e.g., P(X=64)) is 0, as probability is measured over intervals, not points. Thus, 0 students, as per the document.
Patients should be instructed regarding the rapid onset of zolpidem (Ambien) because:
- A. Zolpidem should be taken just before going to bed.
- B. Zolpidem may cause dry mouth and constipation.
- C. Patients may need to double the dose for effectiveness.
- D. They should stop drinking alcohol at least 30 minutes before taking zolpidem.
Correct Answer: A
Rationale: Zolpidem's rapid onset requires bedtime administration to prevent falls or amnesia.
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