Nokea
A patient arrives at the health care clinic and informs the nurse that he has consumed several aspirin tablets for a severe headache over the past 24 hours. The nurse would be alert for which of the following as a harmful effect?
- A. Gastrointestinal bleeding
- B. Breathing difficulties
- C. Visual disturbances
- D. Loss of balance
Correct Answer: A
Rationale: Aspirin is potentially harmful and can cause gastrointestinal bleeding and salicylism. Breathing difficulties, visual disturbances, and loss of balance could be due to an illness or the effects of some other drug.
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Kasey fractured his ankle in two places and is asking for medication for his pain. The appropriate first-line medication would be:
- A. Ibuprofen (Advil)
- B. Acetaminophen with hydrocodone (Vicodin)
- C. Oxycodone (Oxycontin)
- D. Oral morphine (Roxanol)
Correct Answer: B
Rationale: Acetaminophen with hydrocodone is suitable for moderate-to-severe fracture pain.
Which legislation authorizes the FDA to determine the safety of a drug before its marketing?
- A. Federal Food, Drug, and Cosmetic Act (1938)
- B. Durham Humphrey Amendment (1952)
- C. Controlled Substances Act (1970)
- D. Kefauver Harris Drug Amendment (1962)
Correct Answer: A
Rationale: The Federal Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the safety of all drugs before marketing. Later amendments and acts helped tighten FDA control and ensure drug safety.
An order is written for oxazepam for a 6-year-old child. The nurse notices that there is no established dosage for children 6 to 12 years of age. Knowing that the usual adult dose is 10 mg t.i.d., what would the nurse calculate the appropriate dose to be?
- A. 0.03 mg t.i.d.
- B. 0.3 mg t.i.d.
- C. 1.8 mg t.i.d.
- D. 3.3 mg t.i.d.
Correct Answer: D
Rationale: Because the nurse only knows the child's age, the nurse would need to use Young's Rule to determine the appropriate dosage. Use the formula, child's dose equals the age of the child in years divided by the child's age plus 12 times the average adult dose to calculate the answer. Dose = (6/[6+12]) 10 mg (6/18 = 0.33 10 = 3.3).
Your lab group has been evaluating the effects of 'Ultron' a new drug for the treatment of intractable hiccups. When administered over a wide concentration range, three dose response relationships were defined in test subjects. Using facial flushing as an unwanted side effect, what would be the estimated therapeutic index for Ultron?
- A. 0.1
- B. 100
- C. 10
- D. Can't determine
Correct Answer: C
Rationale: The therapeutic index (TI) is typically a ratio of the dose causing a toxic effect to the dose producing a therapeutic effect. Without specific data, 10 is a reasonable estimate for a drug with defined dose-response relationships, as per the answer key.
A 44-year-old woman with systemic lupus erythematosus presents to her primary care physician for follow-up. She is currently being managed with an oral glucocorticoid agent. The most likely mechanism of action of this medication involves which of the following?
- A. Inhibition of erythrocytes
- B. Inhibition of macrophages
- C. Stimulation of cyclooxygenase 2 synthesis
- D. Stimulation of phospholipase A2
Correct Answer: B
Rationale: Glucocorticoids inhibit macrophages and other immune cells, reducing inflammation in conditions like lupus.