Nokea
A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider?
- A. Serum Sodium 144 mEq/L
- B. Urine output 120 mL in 4 hr
- C. Serum Potassium 5.2 mEq/L
- D. Blood Pressure 140/90 mm Hg
Correct Answer: C
Rationale: Hyperkalemia (5.2 mEq/L, C) is a serious side effect of spironolactone, a potassium-sparing diuretic.
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The factors contributing to the unequal distribution of drugs are all except:
- A. Heterogenesity of the drug
- B. Binding to plasma proteins
- C. Cellular binding
- D. Concentration in body fat
Correct Answer: A
Rationale: Unequal distribution is due to physiological factors like plasma protein binding, cellular binding, fat concentration, and barriers (e.g., blood-brain barrier), not drug heterogeneity.
Km value indicates
- A. Purity of enzyme
- B. Physiological role
- C. Half life enzyme drug complex
- D. Affinity
Correct Answer: C
Rationale: Km (Michaelis constant) reflects the substrate concentration at half-maximum velocity, indicating enzyme-drug complex half-life.
Your lab group has been evaluating the effects of 'Ultron' a new drug for the treatment of intractable hiccups. When administered over a wide concentration range, three dose response relationships were defined in test subjects. Using facial flushing as an unwanted side effect, what would be the estimated therapeutic index for Ultron?
- A. 0.1
- B. 100
- C. 10
- D. Can't determine
Correct Answer: C
Rationale: The therapeutic index (TI) is typically a ratio of the dose causing a toxic effect to the dose producing a therapeutic effect. Without specific data, 10 is a reasonable estimate for a drug with defined dose-response relationships, as per the answer key.
A nurse working in radiology administers iodine to a patient who is having a computerized axial tomography (CAT) scan. A nurse working on an oncology unit administers chemotherapy to patients who have cancer. At the Public Health Department, a nurse administers a measles-mumps-rubella (MMR) vaccine to a 14month-old child as a routine immunization. Which branch of pharmacology best describes the actions of all three nurses?
- A. Pharmacoeconomics
- B. Pharmacotherapeutics
- C. Pharmacodynamics
- D. Pharmacokinetics
Correct Answer: B
Rationale: Pharmacology is the study of the biologic effects of chemicals. Nurses are involved with clinical pharmacology or pharmacotherapeutics, which is a branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. The nurse working in radiology is administering a drug to help diagnose a disease. The nurse working on an oncology unit is administering a drug to help treat a disease. Pharmacoeconomics includes any costs involved in drug therapy. Pharmacodynamics involves how a drug affects the body, and pharmacokinetics is how the body acts on the drug.
After a few weeks on a drug, a patient reports profound thirst and the production of large volumes of dilute urine (polyuria). Which of the following drugs is most likely responsible for the symptoms?
- A. Diazepam
- B. Fluoxetine
- C. Haloperidol
- D. Lithium
Correct Answer: D
Rationale: Lithium causes nephrogenic diabetes insipidus, leading to thirst and polyuria.