Nokea
A nurse is reviewing laboratory findings and notes that a client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?
- A. Perform immediate gastric lavage.
- B. Prepare the client for hemodialysis.
- C. Administrative and additional oral dose of lithium.
- D. Request a stat repeat of the laboratory test
Correct Answer: B
Rationale: A level of 2.1 mEq/L indicates toxicity (normal 0.6-1.2 mEq/L); hemodialysis is used for severe cases.
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While receiving treatment for acute pulmonary edema, a woman complains of tinnitus and vertigo.
- A. Clomiphene
- B. Hydrochlorothiazide
- C. Furosemide
- D. Mifepristone
Correct Answer: C
Rationale: Furosemide, a loop diuretic, can cause ototoxicity (tinnitus, vertigo) at high doses.
Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her:
- A. To not abruptly discontinue levetiracetam due to risk for withdrawal seizures
- B. To wear sunscreen due to photosensitivity from levetiracetam
- C. To get an annual eye exam while on levetiracetam
- D. To report weight loss if it occurs
Correct Answer: A
Rationale: Abrupt discontinuation of levetiracetam risks withdrawal seizures.
Which of the following drugs interacts with nitroglycerine by inhibiting the metabolism of cGMP?
- A. Amyl nitrite
- B. Sildenafil
- C. Isosorbide mononitrate
- D. Nifedipine
Correct Answer: B
Rationale: Sildenafil, a PDE5 inhibitor, increases cGMP, enhancing nitroglycerin's hypotensive effect.
A 52-year-old overweight woman presents to the clinic for a diabetes management. She had not been doing well controlling her blood sugars with metformin. Her last hemoglobin A1c was 13.4%, despite her taking her medication every day. The physician decides to start her on a long-acting insulin that is injected only once a day for better glucose control. Also, he wants the insulin to have a minimal risk of hypoglycemia. What is the most likely medication given to this patient?
- A. Insulin aspart
- B. Insulin glargine
- C. Insulin lispro
- D. NPH insulin
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin administered once daily, with a lower risk of hypoglycemia compared to other insulins.
Which of the following is not hypoglicemic mechanism of action of metformin?
- A. Enhance insulin release by pancreatic beta cells
- B. Increase cell permeability of glucose and utilisation
- C. Decrease gluconeogenesis
- D. Interfere carbohydrate absorption in the gut
Correct Answer: A
Rationale: Metformin does not enhance insulin release; it improves insulin sensitivity and reduces hepatic glucose production.