Nokea
A contraindication for topical corticosteroid usage in a male with atopic dermatitis (eczema) is:
- A. Parasite infection
- B. Viral infection
- C. Bacterial infection
- D. Spirochete infection
Correct Answer: B
Rationale: Topical corticosteroids worsen viral infections (e.g., herpes) due to immunosuppression.
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Jake, a 45-year-old patient with schizophrenia, was recently hospitalized for acute psychosis due to medication noncompliance. He was treated with IM long-acting haloperidol. Besides monitoring his schizophrenia symptoms, the patient should be assessed by his primary care provider:
- A. For excessive weight loss
- B. With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS)
- C. Monthly for tolerance to the haloperidol
- D. Only by the mental health provider, as most NPs in primary care do not care for mentally ill patients
Correct Answer: B
Rationale: Haloperidol can cause EPS, monitored using the AIMS.
Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?
- A. A 35-year-old woman with cervical cancer
- B. A 41-year-old man with kidney stones
- C. A 50-year-old man with cirrhosis of the liver
- D. A 62-year-old woman in acute renal failure
Correct Answer: C
Rationale: The liver is the most important site of drug metabolism. If the liver is not functioning effectively, as in patients with cirrhosis, drugs will not metabolize normally so that toxic levels could develop unless dosage is reduced. A patient with cervical cancer or kidney stones would not be expected to have altered ability to metabolize drugs so long as no liver damage existed. The patient with renal failure would have altered excretion of the drugs through the renal system but metabolism would not be impacted.
Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it:
- A. Increases peripheral vasoconstriction
- B. Decreases detrusor muscle contractility
- C. Lowers supine blood pressure more than standing pressure
- D. Relaxes smooth muscle in the bladder neck
Correct Answer: D
Rationale: Doxazosin, an alpha-1 blocker, relaxes bladder neck smooth muscle, aiding BPH, and lowers blood pressure.
Which mode of action has insulin in fatty cells?
- A. Decrease glycerol synthesis
- B. Increase synthesis of triglycerides
- C. Decrease fatty acid synthesis
Correct Answer: B
Rationale: Insulin promotes triglyceride synthesis in fat cells by enhancing glucose uptake and lipogenesis.
Which lab test(s) would be used to assess liver and/or renal function before administering medications? (Select one that does not apply.)
- A. CBC
- B. LDH
- C. ALT
- D. Crs
Correct Answer: A
Rationale: Liver function tests include LDH (lactic dehydrogenase) and ALT (alanine aminotransferase). Renal function tests include Crs (serum creatinine) and BUN (blood urea nitrogen). Although a CBC (complete blood count) and an aPTT are useful in assessing the patient before administration of medication, they are not renal or hepatic function tests.