Nokea
A client has just been prescribed with methotrexate (Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is to?
- A. Clay-colored stool is a normal response to the treatment.
- B. Pregnancy is not contraindicated with the use of the medication.
- C. Strict hand washing.
- D. Get a daily source of sunlight during the day.
Correct Answer: C
Rationale: Methotrexate is an immunosuppressant, increasing the risk of infections. Strict hand washing and infection prevention measures are crucial. Clay-colored stools are not normal and may indicate liver dysfunction. Pregnancy is contraindicated due to the risk of fetal harm. Sunlight exposure should be limited to reduce the risk of photosensitivity reactions.
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Depression that occurs during cold winter months would be classified as
- A. baby blues
- B. bipolar disorder
- C. seasonal affective disorder
- D. obsessive-compulsive disorder
Correct Answer: C
Rationale: Seasonal affective disorder (SAD) ties depression to winter-less light, per psychiatry-unlike baby blues (postpartum), bipolar (cycles), or OCD (obsessions). SAD's seasonal link defines it, matching symptoms.
Enteric coated acetylsalicylic acid has been prescribed for a patient to treat chronic arthritis. The patient calls the clinic nurse because of gagging and difficulty swallowing the tablets. What response would the nurse give to the patient?
- A. Crush the tablets and mix with juice or food'
- B. I’ll notify the healthcare provider for a medication change'
- C. Open the tablet and mix the contents with food'
- D. Swallow the tablets with large amounts of water or milk'
Correct Answer: D
Rationale: Enteric-coated tablets should not be crushed or opened, as this disrupts their protective coating and can cause gastric irritation. The patient should be instructed to swallow the tablets whole with plenty of water or milk. Crushing (A) or opening the tablets (C) is inappropriate. Notifying the healthcare provider (B) may be necessary if the patient cannot tolerate the medication.
Which of the following agents exerts its therapeutic effect in multiple sclerosis via potassium channel blockade?
- A. Dalfampridine
- B. Donepezil
- C. Riluzole
- D. Bromocriptine
Correct Answer: A
Rationale: Dalfampridine treats MS by blocking potassium channels in demyelinated axons, enhancing nerve conduction and improving walking ability. Exposed potassium channels in MS leak current, impairing signal propagation; dalfampridine's blockade restores function. Donepezil boosts acetylcholine for Alzheimer's. Riluzole reduces glutamate in ALS. Bromocriptine, a dopamine agonist, manages Parkinson's. Dalfampridine's unique potassium channel action directly addresses MS's neurological deficit, supported by clinical evidence, making it the correct agent here.
If you inject a drug with a pH of 6.5 and pka of 8.1 into a tissue with a pH of 7.4, to what extent would you expect this drug to be ionized in the tissue?
- A. over 50%
- B. 50%
- C. under 50%
- D. 100%
Correct Answer: A
Rationale: The percentage of ionization of a weak acid or base can be estimated using the Henderson-Hasselbalch equation:
Morphine over dose is treated with_____
- A. Naloxone
- B. Vitamin K
- C. Time
- D. Grapefruit juice
Correct Answer: A
Rationale: Morphine overdose is a medical emergency that can result in respiratory depression and potentially lead to death. Naloxone is a medication used to counteract the effects of opioids like morphine by binding to the same receptors in the brain and reversing the respiratory depression. Naloxone works quickly to restore normal breathing and consciousness in individuals who have overdosed on morphine. It is a critical intervention used to prevent fatal outcomes of opioid overdose, including morphine. Other options like Vitamin K, time, and grapefruit juice are not effective treatments for morphine overdose.