Nokea
A newly developed medication for pulmonary hypertension targets blood vessels in the lungs, but does not affect blood vessels in the liver. Which of the following is most likely true of this medication?
- A. It is a ligand that is specific for lung and liver blood-vessel receptors. but which is metabolized rapidly in the liver
- B. It is a ligand that is specific for blood-vessel receptors in the lung but not in the liver
- C. It is a receptor that is upregulated when oxygen tension in the lungs is low
- D. It is a receptor that is only expressed on blood vessels in the lungs
Correct Answer: B
Rationale: The medication's specificity for lung blood vessels suggests it targets receptors unique to that tissue, not the liver.
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Samantha is taking lamotrigine (Lamictal) for her seizures and requests a prescription for combined oral contraceptives (COCs), which interact with lamotrigine and may cause:
- A. Contraceptive failure
- B. Excessive weight gain
- C. Reduced lamotrigine levels, requiring doubling the dose of lamotrigine
- D. Induction of estrogen metabolism, requiring higher estrogen content OCs be prescribed
Correct Answer: C
Rationale: COCs induce lamotrigine metabolism, lowering its levels and requiring dose adjustment.
What does the provider understand about the issue of 'Diabetic Renal Protection' with angiotensin-converting enzyme (ACE) medications? Diabetes mellitus patients:
- A. Have a reduced rate of renal progression, but still need to be discontinued when advanced renal issues present
- B. Who start these medications never progress to renal nephropathy
- C. With early renal dysfunction will see it reverse when on ACE medications
- D. Without renal issues are the only ones who benefit from ACE protection
Correct Answer: A
Rationale: ACE inhibitors slow renal progression in diabetes but are stopped in advanced renal failure.
What is the role of calcium supplements when patients take bisphosphonates?
- A. They must be restricted to allow the medication to work
- B. They must be taken in sufficient amounts to provide foundational elements for bone growth
- C. They must be taken at the same time as the bisphosphonates
- D. They only work with bisphosphonates if daily intake is restricted
Correct Answer: B
Rationale: Calcium supports bone health with bisphosphonates but must be timed separately (not C) to avoid interference.
Which of the following antiarrhythmic agents has the longest plasma half-life?
- A. Amiodarone
- B. Disopyramide
- C. Quinidine
- D. Disopyramide
Correct Answer: A
Rationale: Amiodarone has a half-life of weeks due to extensive tissue distribution.
A nurse is administering a Dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication?
- A. Lowered heart rate
- B. Increased myocardial contractility
- C. Decreased conduction through the AV node
- D. Vasoconstriction of renal blood vessel
Correct Answer: B
Rationale: Low-dose dopamine increases contractility via beta-adrenergic effects, improving cardiac output.