Nokea
A nurse is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The nurse should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?
- A. Bursitis
- B. Brussels
- C. Depression
- D. Glaucoma
Correct Answer: D
Rationale: Oxybutynin is contraindicated in glaucoma due to its anticholinergic effects increasing intraocular pressure.
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Jim presents with complaints of 'heartburn' that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would be:
- A. Omeprazole (Prilosec) twice a day
- B. Ranitidine (Zantac) twice a day
- C. Famotidine (Pepcid) once a day
- D. Metoclopramide (Reglan) four times a day
Correct Answer: B
Rationale: Ranitidine , an H2 blocker, is a standard first-line GERD treatment; PPIs are next-step, and metoclopramide is for motility.
A patient is using the Commit lozenge 2 mg to help quit smoking and reports nausea and indigestion. The nurse will instruct the patient to perform which action?
- A. Allow the lozenge to dissolve slowly over 20 to 30 minutes
- B. Chew the lozenge thoroughly before swallowing it
- C. Increase to 4 mg and use less often
- D. Take the lozenge with food and a full glass of water
Correct Answer: A
Rationale: Slow dissolution minimizes GI upset from nicotine lozenges; chewing worsens it. The patient should allow the lozenge to dissolve slowly.
A patient has a drug level of 50 units/mL and the drug's half-life is 1 hour. If concentrations above 25 units/mL are considered toxic and no more drug is given, how long will it take for the blood level to reach the nontoxic range?
- A. 30 minutes
- B. 1 hour
- C. 2 hours
- D. 3 hours
Correct Answer: C
Rationale: Half-life is the time required for the serum concentration of a drug to decrease by 50%. After 1 hour, the serum concentration would be 25 units/mL (50/2). After 2 hours, the serum concentration would be 12.5 units/mL (25/2) and reach the nontoxic range.
Which of the following drug increase the sensitivity of fatty tissue and muscles towards insulin:
- A. Dapagliphlozin
- B. Miglitol
- C. Nateglinide
- D. Rosiglitasone
Correct Answer: D
Rationale: Rosiglitazone, a thiazolidinedione, enhances insulin sensitivity in fat and muscle via PPAR-gamma activation.
After teaching a group of nursing students about pharmacokinetics, the instructor determines that the teaching was successful when the students identify which of the following as the site for the metabolism of most drugs?
- A. Liver
- B. Lungs
- C. Kidneys
- D. Intestinal mucosa
Correct Answer: A
Rationale: Although the kidneys, lungs, plasma, and intestinal mucosa may aid in the metabolism of drugs, most drugs are metabolized by the liver.