Nokea
A nurse is teaching a female client who has tobacco use disorder about Nicotine replacement therapy. Which of the following statements by the client indicates understanding of the teaching?
- A. I should avoid eating right before I chew a piece of nicotine gum.
- B. I will need to stop using the nicotine gum after 1 year.
- C. I know that nicotine gum is a safe alternative to resulting if I become pregnant.
- D. I must chew the nicotine gum quickly for about 15 minutes.
Correct Answer: A
Rationale: Avoiding food before chewing enhances nicotine absorption; gum isn't safe in pregnancy, and chewing is slow.
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A 24 year-old man with a history of substance abuse is suffering from generalized anxiety disorder. Which of the following drugs would be the most suitable for the management of his condition?
- A. Zolpidem
- B. Buspirone
- C. Midazolam
- D. Triazolam
Correct Answer: B
Rationale: Buspirone, a non-benzodiazepine, treats anxiety without dependence risk.
While administering a medication that the nurse has researched and found to have limited effectiveness, the patient tells the nurse, I have read all about this drug and it is such a wonder drug. I'm so lucky my doctor prescribed it because I just know it will treat my problem. The nurse suspects this drug will be more effective than usual for this patient because of what effect?
- A. Cumulative effect
- B. First-pass effect
- C. Placebo effect
- D. Cross-tolerance effect
Correct Answer: C
Rationale: A drug is more likely to be effective if the patient thinks it will work than if the patient believes it will not work. This is called the placebo effect. If a drug is taken in successive doses at intervals that are shorter than recommended, or if the body is unable to eliminate a drug properly, the drug can accumulate in the body, leading to toxic levels and adverse effects. This is a cumulative effect. First-pass effect addresses the reduction of available drug when taken orally due to metabolism in the liver before the drug reaches the bloodstream. Cross-tolerance is resistance to drugs within the same class.
Ciprofloxacin increases the toxicity of theophylline by
- A. Inhibiting metabolism
- B. Decreasing excretion
- C. Decrease seizure threshold
- D. Promote absorption
Correct Answer: B
Rationale: Ciprofloxacin reduces theophylline clearance, decreasing excretion.
Rifampin is a nonspecific CYP450 inducer that may:
- A. Lead to toxic levels of rifampin and must be monitored closely
- B. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
- C. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure
- D. Cause nonspecific changes in drug metabolism
Correct Answer: C
Rationale: Rifampin induces CYP450, speeding metabolism of drugs like oral contraceptives , reducing efficacy, not causing toxicity or nonspecificity .
A nurse is assessing a client and notes that the client has developed swelling of the eyelids and lips after administration of a prescribed medication. The nurse interprets this finding as specifically indicating which of the following?
- A. Mild allergic reaction
- B. Anaphylactic shock
- C. Angioedema
- D. Drug idiosyncrasy
Correct Answer: C
Rationale: Angioedema is a type of allergic drug reaction manifested by the collection of fluid in the subcutaneous tissues, most commonly affecting the eyelids, lips, mouth, and throat. Allergic reactions can be manifested by a wide range of signs and symptoms such as itching, rashes, and hives. Anaphylactic shock is a serious allergic reaction that requires immediate medical attention. Drug idiosyncrasy describes any unusual or abnormal reaction to a drug, one that is different from the one normally expected.