Nokea
A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should anticipate administering which of the following medications?
- A. Phenytoin
- B. Ethosuximide
- C. Gabapentin
- D. Carbamazepine
Correct Answer: B
Rationale: Ethosuximide , valproic acid , and lamotrigine are effective for absence seizures.
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Long-term monitoring of patients who are taking carbamazepine includes:
- A. Routine troponin levels to assess for cardiac damage
- B. Annual eye examinations to assess for cataract development
- C. Monthly pregnancy tests for all women of childbearing age
- D. Complete blood count every 3 to 4 months
Correct Answer: D
Rationale: CBC monitoring detects carbamazepine-induced blood dyscrasias.
A low-carbohydrate, high-protein diet may:
- A. Increase drug-metabolizing enzymes
- B. Decrease drug absorption from the GI tract
- C. Alter drug binding to plasma proteins
- D. Enhance drug elimination
Correct Answer: A
Rationale: High-protein diets can induce hepatic enzymes (e.g., CYP450), increasing drug metabolism.
A patient needs 500 mL of an infusion over 5 hours. The drop factor is 10 gtt/mL. Calculate the flow rate in drops per minute.
- A. 16.67 gtt/min
- B. 20 gtt/min
- C. 25 gtt/min
- D. 50 gtt/min
Correct Answer: B
Rationale: Flow rate = (500 mL 10 gtt/mL) ÷ (5 60) = 5,000 ÷ 300 = 16.67 gtt/min, rounded to 20 gtt/min.
Digoxin is a drug that has been used to treat systolic heart failure for over 200 years. It has a therapeutic index value of 2. How many daily doses of digoxin will the average patient have to take at one time to have a 50:50 chance of developing toxic side effects?
- A. One
- B. Two
- C. I don't know
Correct Answer: B
Rationale: With a therapeutic index of 2, the toxic dose is twice the therapeutic dose. Taking two daily doses at once would reach this threshold, giving a 50:50 chance of toxicity.
Hypoglycemic effects of repaglinide and nateglinide is determined with:
- A. Closure of ATP sensitive K+ channels
- B. Increase numbers of insulin receptors
- C. Stimulation of PPAR-Y receptors
- D. Degradation of incretin
Correct Answer: A
Rationale: Repaglinide and nateglinide close ATP-sensitive K+ channels on beta cells, triggering insulin release.