Nokea
A nurse is providing teaching to a client who has a new prescription for Amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching?
- A. Expect therapeutic effects in 24 to 48 hr.
- B. Discontinue the medication after a week of improved mood.
- C. Change positions slowly to minimize dizziness.
- D. Decrease injury from the first dose.
Correct Answer: C
Rationale: Slow position changes prevent dizziness, and chewing gum relieves dry mouth, common with tricyclics like amitriptyline.
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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 nurse is instructing a client who has a new prescription for Timolol how to insert eye drops. The nurse should instruct the client to press on which of the following areas to prevent systemic absorption of the medication?
- A. Bony orbit
- B. Nasolacrimal duct
- C. Conjunctival sac
- D. Outer canthus
Correct Answer: B
Rationale: Pressing the nasolacrimal duct prevents systemic absorption by blocking drainage into the nasal cavity.
The following drug is used for diabetic coma:
- A. Glibenclamid
- B. Long acting insulin preparations
- C. The rapid and intermediate acting insulin preparations
- D. Metformin
Correct Answer: C
Rationale: Rapid and intermediate-acting insulins are used to quickly correct hyperglycemia in diabetic coma.
Pregnant women should receive the Tdap vaccine:
- A. In the first trimester
- B. Once every 10 years
- C. In the third trimester of every pregnancy
- D. Tdap is contraindicated in pregnancy
Correct Answer: C
Rationale: Tdap in the third trimester protects newborns from pertussis; it's not contraindicated or trimester-specific otherwise.
Many patients with hyperlipidemia are treated with more than one drug. Combining a fibric acid derivative such as gemfibrozil with which of the following is not recommended? The drug and the reason must both be correct for the answer to be correct.
- A. Reductase inhibitors, due to an increased risk for rhabdomyolysis
- B. Bile-acid sequestering resins, due to interference with folic acid absorption
- C. Grapefruit juice, due to interference with metabolism
- D. Niacin, due to decreased gemfibrozil activity
Correct Answer: A
Rationale: Gemfibrozil with statins increases rhabdomyolysis risk.