A patient is prescribed a buccal medication. The nurse would instruct the patient to place the drug at which location?
- A. Under the tongue
- B. Against the cheek mucous membrane
- C. Inside the rectum
- D. At the back of the tongue
Correct Answer: B
Rationale: Buccal drugs are placed in the mouth against the mucous membranes of the cheek in either the upper or lower jaw. Sublingual medications are placed under the tongue. Rectal suppositories are inserted into the rectum. Oral medications are placed at the back of the tongue.
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The volume of distribution (Vd) for a drug that is completely retained in the vascular compartment would be?
- A. High
- B. Low
- C. Unchanged
- D. Cannot be determined
Correct Answer: B
Rationale: A drug confined to the vascular compartment (e.g., plasma) has a low Vd, close to plasma volume (about 0.06 L/kg), indicating limited distribution.
Which statement accurately describes a drug agonist?
- A. A drug that reacts with specific receptor sites on a cell and prevents the reaction of another chemical with a different receptor site on that cell
- B. A drug that interferes with the enzyme systems that act as catalysts for different chemical reactions
- C. A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site
- D. A drug that reacts with receptor sites to block normal stimulation, producing no effect
Correct Answer: C
Rationale: Agonists are drugs that produce effects similar to those produced by naturally occurring neurotransmitters, hormones, or other substances found in the body. Noncompetitive antagonists are drugs that react with certain receptor sites, preventing the reaction of another chemical with a different receptor site. Drug-enzyme interactions interfere with the enzyme systems that stimulate various chemical reactions.
Pregnant patients who are taking isoniazid (INH) should take 25 mg/day of vitamin B6 (pyridoxine) to prevent:
- A. Beriberi
- B. Peripheral neuropathy
- C. Rickets
- D. Megaloblastic anemia
Correct Answer: B
Rationale: Vitamin B6 supplementation prevents INH-induced peripheral neuropathy.
Isoproterenol produces maximal contraction of cardiac muscle in a manner similar to epinephrine. Which of the following best describe isoproterenol?
- A. Fuller agonist
- B. Partial agonist
- C. Irreversible antagonist
- D. Inverse agonist
Correct Answer: A
Rationale: Isoproterenol's maximal effect similar to epinephrine indicates it is a full agonist at beta receptors.
Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages for her should be:
- A. Started at about half the usual dosage
- B. Not increased over the usual dosage for an adult
- C. Given once daily because of memory issues in the older adult
- D. Withheld if she experiences gastroesophageal reflux
Correct Answer: A
Rationale: Elderly patients start at half dose due to reduced metabolism and clearance.
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