Nokea
A nurse is caring for a client who has Atrial Fibrillation and a new prescription for Dabigatran to prevent development of Thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of Dabigatran?
- A. Vitamin k1
- B. Protamine
- C. Omeprazole
- D. Probenecid
Correct Answer: C
Rationale: Omeprazole reduces dabigatran's GI bleeding risk, a common side effect.
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A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:
- A. Coumadin, which may lead to bleeding problems
- B. Coumarin, which can cause liver and kidney damage
- C. Cinnamic aldehyde, which is toxic to the kidney
- D. Cinnamate eugenol, which is toxic to the liver
Correct Answer: B
Rationale: Cassia cinnamon contains coumarin, which can be hepatotoxic and nephrotoxic in high doses.
Which of the following concepts is considered when generic drugs are substituted for brand-name drugs?
- A. Bioavailability
- B. Critical concentration
- C. Distribution
- D. Half-life
Correct Answer: A
Rationale: Bioavailability is the portion of a dose of a drug that reaches the systemic circulation and is available to act on body cells. Binders used in a generic drug may not be the same as those used in the brand-name drug. Therefore, the way the body breaks down and absorbs the drug may differ, affecting its bioavailability.
A patient has been using sleeping pills every night for the past several months. Now admitted to the hospital, he is prescribed his usual dose of sleeping pill. After administration, the patient continues to be restless and is wide awake. The nurse notifies the health care provider, who prescribes an increased dose. After receiving the new dose, the patient falls asleep. The nurse interprets this as which of the following?
- A. Drug idiosyncrasy
- B. Cumulative drug effect
- C. Drug tolerance
- D. Toxic reactions
Correct Answer: C
Rationale: The patient has developed drug tolerance and has to be administered an increased dosage of the drug to achieve the desired effect. Cumulative drug effect occurs when the body is unable to metabolize and excrete one (normal) dose of a drug before the next dose is given. Drug idiosyncrasy is a term used to describe any unusual or abnormal reaction to a drug. Toxic reactions are caused when blood concentration levels exceed the therapeutic levels of a drug.
When writing a prescription for warfarin it is common to write ____ on the prescription.
- A. OK to substitute for generic
- B. The brand name of warfarin and Do Not Substitute
- C. PRN refills
- D. Refills for 1 year
Correct Answer: B
Rationale: Brand-specific warfarin ensures consistent potency; generics vary slightly, and PRN or yearly refills are impractical.
GLP-1 agonists:
- A. Directly bind to a receptor in the pancreatic beta cell
- B. Have been approved for monotherapy
- C. Speed gastric emptying to decrease appetite
- D. Can be given orally once daily
Correct Answer: A
Rationale: GLP-1 agonists bind beta-cell receptors to enhance insulin release; they're not monotherapy-approved or oral .