Nokea
A nurse is providing information to a client who has a new prescription for Hydrochlorothiazide. Which of the following information should the nurse include?
- A. Take the medication with food.
- B. Plan to take the medication at bedtime.
- C. Expect increased swelling of the ankles.
- D. Fluid intake should be limited in the morning.
Correct Answer: A
Rationale: Taking with food reduces GI upset, a standard instruction for hydrochlorothiazide.
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Because of the pattern of cholesterol synthesis, reductase inhibitors are given:
- A. In the evening in a single daily dose
- B. Twice daily in the morning and the evening
- C. With each meal and at bedtime
- D. In the morning before eating
Correct Answer: A
Rationale: Cholesterol synthesis peaks at night, so evening dosing optimizes reductase inhibitor efficacy.
The nurse uses what term to describe the drug level required to have a therapeutic effect?
- A. Critical concentration
- B. Dynamic equilibrium
- C. Selective toxicity
- D. Active transport
Correct Answer: A
Rationale: A critical concentration of a drug must be present before a reaction occurs within the cells to bring about the desired therapeutic effect. A dynamic equilibrium is obtained from absorption of a drug from the site of drug entry, distribution to the active site, metabolism in the liver, and excretion from the body to have a critical concentration. Selective toxicity is the ability of a drug to attach only to those systems found in foreign cells. Active transport is the process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney.
Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:
- A. Dwayne hasn't been taking his carbamazepine because it causes insomnia.
- B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
- C. Dwayne was not originally prescribed the correct amount of carbamazepine.
- D. Carbamazepine is probably not the right antiseizure medication for Dwayne.
Correct Answer: B
Rationale: Carbamazepine induces its own metabolism (auto-induction), reducing levels over time.
Fasting for an extended period can:
- A. Increase drug absorption due to lack of competition between food and the drug
- B. Alter the pH of the gastrointestinal tract, affecting absorption
- C. Cause vasoconstriction, leading to decreased drug absorption
- D. Shrink the stomach, causing decreased surface area for drug absorption
Correct Answer: A
Rationale: Fasting increases absorption of some drugs by eliminating food-related delays in gastric emptying and competition for absorption.
Which of the following glucocorticoid is used for intra-articular injection for treatment of arthrites:
- A. Triamcinolon
- B. Budesonide
- C. Prednisolon
- D. Hydrocortison
Correct Answer: A
Rationale: Triamcinolone is commonly used for intra-articular injections due to its potent anti-inflammatory effects in treating arthritis.