Nokea
A client newly diagnosed with diabetes tells the nurse, 'I can't take any insulin made from pigs or cows.' Which of the following responses by the nurse is best?
- A. Most insulin comes from animal sources, but I'm sure alternative options are available.'
- B. Medications that are derived from animals are typically less expensive than synthetic medications, but synthetic insulin is commonly available.'
- C. Most insulin is synthetic now to help reduce the risk of disease transmission.'
- D. The animals aren't hurt in the production of medications, so you don't need to worry.'
Correct Answer: C
Rationale: Most insulin today is synthetic (e.g., recombinant DNA technology), reducing disease transmission risks and addressing patient concerns about animal sources effectively.
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While receiving treatment for acute pulmonary edema, a woman complains of tinnitus and vertigo.
- A. Clomiphene
- B. Hydrochlorothiazide
- C. Furosemide
- D. Mifepristone
Correct Answer: C
Rationale: Furosemide, a loop diuretic, can cause ototoxicity (tinnitus, vertigo) at high doses.
A 52-year-old overweight woman presents to the clinic for a diabetes management. She had not been doing well controlling her blood sugars with metformin. Her last hemoglobin A1c was 13.4%, despite her taking her medication every day. The physician decides to start her on a long-acting insulin that is injected only once a day for better glucose control. Also, he wants the insulin to have a minimal risk of hypoglycemia. What is the most likely medication given to this patient?
- A. Insulin aspart
- B. Insulin glargine
- C. Insulin lispro
- D. NPH insulin
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin administered once daily, with a lower risk of hypoglycemia compared to other insulins.
A nurse is planning to administer a first dose of Captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select one that does not apply.)
- A. Simvastatin
- B. Hydrochlorothiazide
- C. aliskiren
- D. Clonidine
Correct Answer: A
Rationale: Diuretics , clonidine , and aliskiren enhance hypotension with captopril's first dose.
The choice of diuretic to use in treating hypertension is based on:
- A. Presence of diabetes with loop diuretics being used for these patients
- B. Level of kidney function with a thiazide diuretic being used for an estimated glomerular filtration rate higher than the mid-40 mL/min range
- C. Ethnicity with aldosterone antagonists best for African Americans and older adults
- D. Presence of hyperlipidemia with higher doses needed for patients with LDL above 130 mg/dL
Correct Answer: B
Rationale: Thiazides are effective with GFR >40-50 mL/min; loops are used for lower GFR.
Herbs and supplements are regulated by the U.S. Food and Drug Administration.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: Herbs and supplements are not regulated as drugs by the FDA; they fall under dietary supplement rules.