Nokea
A patient may develop neutropenia from using topical Silvadene for burns. Neutropenia is a(n):
- A. Cytotoxic hypersensitivity reaction
- B. Immune complex hypersensitivity
- C. Immediate hypersensitivity reaction
- D. Delayed hypersensitivity reaction
Correct Answer: A
Rationale: Neutropenia from Silvadene (silver sulfadiazine) is a Type II cytotoxic reaction , targeting blood cells, not immune complex , immediate , or delayed .
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A patient receiving gentamicin should be monitored for which potential adverse effect?
- A. Nephrotoxicity
- B. Hepatotoxicity
- C. Ototoxicity
- D. Both A and C
Correct Answer: D
Rationale: Gentamicin, an aminoglycoside, commonly causes nephrotoxicity and ototoxicity , requiring monitoring of renal function and hearing.
What concept is considered when generic drugs are substituted for brand name drugs?
- A. Bioavailability
- B. Critical concentration
- C. Distribution
- D. Half-life
Correct Answer: A
Rationale: Bioavailability is the portion of a dose of a drug that reaches the systemic circulation and is available to act on body cells. Binders used in a generic drug may not be the same as those used in the brand name drug. Therefore, the way the body breaks down and uses the drug may differ, which may eliminate a generic drug substitution. Critical concentration is the amount of a drug that is needed to cause a therapeutic effect and should not differ between generic and brand name medications. Distribution is the phase of pharmacokinetics, which involves the movement of a drug to the body's tissues and is the same in generic and brand name drugs. A drug's half-life is the time it takes for the amount of drug to decrease to half the peak level, which should not change when substituting a generic medication.
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(s) is/are true regarding the types of medication orders? (Select one that does not apply.)
- A. Stat orders are the same as single dose orders.
- B. Verbal orders should be used as much as possible.
- C. Renewal orders facilitate physician review before continuance of high risk medications.
- D. PRN medications will designate a mandatory number of times the medication is to be administered.
Correct Answer: C
Rationale: Standing orders state the frequency of medication dosages to be administered or indicate the time frame of administration. Renewal orders require the physician to review medications that have expired orders, as determined by facility policy. Renewal policies facilitate physician verification of the necessity to continue a medication beyond a usual time frame and help ensure patient safety. Single dose and stat orders are not the same. PRN medications are not ordered a mandatory number of times, although a maximum number might be specified. Verbal orders should be avoided whenever possible.
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.