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A patient has been taking temazepam (Restoril) for intermittent insomnia. She calls the nurse to say that when she takes it, she sleeps well, but the next day she feels 'so tired.' Which explanation by the nurse is correct?
- A. “Long-term use of this drug results in a sedative effect.”
- B. “If you take the drug every night, this hangover effect will be reduced.”
- C. “These drugs affect the sleep cycle, resulting in daytime sleepiness.”
- D. “These drugs increase the activity of the central nervous system (CNS), making you tired the next day.”
Correct Answer: C
Rationale: The correct answer is C: “These drugs affect the sleep cycle, resulting in daytime sleepiness.” Temazepam is a benzodiazepine used for insomnia by enhancing the effects of GABA neurotransmitter, which can disrupt the sleep cycle. This disruption can lead to next-day drowsiness. Choice A is incorrect as long-term use does not increase sedative effects. Choice B is incorrect as taking the drug regularly may not reduce the hangover effect. Choice D is incorrect as benzodiazepines like temazepam actually have a sedative effect and do not increase CNS activity.
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The early stage of cannabis intoxication is characterized by:
- A. Euphoria,uncontrolled laugher
- B. Alteration of time sense,depersonalization
- C. Sharpened vision
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because the early stage of cannabis intoxication typically includes euphoria, uncontrolled laughter, alteration of time sense, depersonalization, and sharpened vision. Euphoria and uncontrolled laughter are common effects of cannabis, while alteration of time sense and depersonalization are also frequently reported. Sharpened vision may occur due to the impact of cannabis on sensory perception. Therefore, all of the above symptoms are characteristic of the early stage of cannabis intoxication. Choices A, B, and C are incorrect because they do not encompass the full range of symptoms commonly associated with cannabis intoxication.
All of the following statements concerning angiotensin converting enzyme (ACE) inhibitors are true EXCEPT:
- A. They act by inhibiting the ability of renin to convert angiotensinogen to angiotensin I.
- B. Enalapril is a prodrug that is converted to an active metabolite
- C. They reduce secretion of aldosterone
- D. They can produce hyperkalemia in combination with a potassium-sparing diuretic
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
A: ACE inhibitors directly inhibit the conversion of angiotensin I to angiotensin II, not angiotensinogen to angiotensin I.
B: Enalapril is indeed a prodrug that is converted to an active metabolite.
C: ACE inhibitors do reduce the secretion of aldosterone.
D: ACE inhibitors can lead to hyperkalemia when combined with a potassium-sparing diuretic due to decreased aldosterone levels.
Barbiturates increase the rate of metabolism of:
- A. Anticoagulants
- B. Digitalis compounds
- C. Glucocorticoids
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Barbiturates are known to increase the metabolism of various drugs, including anticoagulants, digitalis compounds, and glucocorticoids. This is because barbiturates induce liver enzymes responsible for drug metabolism, leading to faster clearance of these medications from the body. Therefore, the correct answer is D as barbiturates can affect the metabolism of all the mentioned drug classes. Choices A, B, and C are incorrect as barbiturates do not selectively increase the metabolism of only one of these drug classes, but rather have a broad impact on drug metabolism.
An oral iron supplement is prescribed for a patient. The nurse would question this order if the patient’s medical history includes which condition?
- A. Decreased hemoglobin
- B. Hemolytic anemia
- C. Weakness
- D. Concurrent therapy with erythropoietics
Correct Answer: B
Rationale: The correct answer is B: Hemolytic anemia. Oral iron supplements can exacerbate hemolytic anemia by increasing the production of red blood cells, which can worsen the condition. Other choices (A, C, D) are not contraindications for prescribing an oral iron supplement. Decreased hemoglobin indicates a need for iron supplementation, weakness can be a symptom of iron deficiency anemia (which would require iron supplementation), and concurrent therapy with erythropoietics can be used in combination with iron supplements to treat anemia.
Which of the following antiseizure drugs binds to an allosteric regulatory site on the GABA-BZ receptor, increases the duration of the Cl-channels openings:
- A. Diazepam
- B. Valproate
- C. Phenobarbital
- D. Topiramate
Correct Answer: C
Rationale: Step-by-step rationale:
1. Phenobarbital binds to an allosteric regulatory site on the GABA-BZ receptor.
2. It enhances the affinity of GABA to its receptor, increasing Cl- channel opening duration.
3. This leads to hyperpolarization and inhibits neuronal excitability, preventing seizures.
4. Diazepam (A) and Valproate (B) act on different receptors.
5. Topiramate (D) modulates ion channels but not through the GABA-BZ receptor.
Summary:
Phenobarbital is the correct answer as it directly targets the GABA-BZ receptor, increasing Cl- channel opening duration. Diazepam, Valproate, and Topiramate act through different mechanisms, making them incorrect choices.