Nokea
A nurse is teaching a client who has a new prescription for Ramelteon. The nurse should instruct the client to avoid which of the following foods while taking this medication?
- A. Baked potato
- B. Fried chicken
- C. Whole-grain bread
- D. Citrus fruits
Correct Answer: B
Rationale: High-fat foods like fried chicken can delay ramelteon's onset, a melatonin receptor agonist.
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The nurse is caring for a patient who is receiving gentamicin, 250 mg and fluconazole (Diflucan), 500 mg at the same time. The nurse knows that if these two drugs competed with each other for protein-binding sites, what would this do?
- A. Make the patient gentamicin deficient
- B. Make the patient fluconazole deficient
- C. Counteract any positive benefit the drugs would have
- D. Alter the effectiveness of both drugs
Correct Answer: D
Rationale: Some drugs compete with each other for protein-binding sites, altering effectiveness or causing toxicity when the two drugs are given together. Nothing in the scenario would indicate that the patient would be either Gentamicin or Diflucan deficient, nor does it indicate that these drugs cannot be given together because they would counteract each other.
Larry has heart failure, which is being treated with digoxin because it exhibits:
- A. Negative inotropism
- B. Positive chronotropism
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: D
Rationale: Digoxin has positive inotropic effects, increasing contractility, not negative or chronotropic.
What is the interaction of pheno barbiton and warfarin
- A. Displacement of warfarin from binding site
- B. Decreased absorption of warfarin
- C. Increased metabolism of warfarin
- D. Decreased metabolism of warfarin
Correct Answer: C
Rationale: Phenobarbitone induces liver enzymes, increasing warfarin metabolism.
First-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they are:
- A. More effective than first-generation antihistamines
- B. Less sedating than the first-generation antihistamines
- C. Prescription products, therefore are covered by insurance
- D. Able to be taken with central nervous system (CNS) sedatives, such as alcohol
Correct Answer: B
Rationale: Loratadine is a second-generation antihistamine, less sedating than first-generation ones; it's not more effective , insurance-driven , or safe with sedatives .
A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this is due to:
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. Once in the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.