Nokea
A patient needs 500 mL of an infusion over 5 hours. The drop factor is 10 gtt/mL. Calculate the flow rate in drops per minute.
- A. 16.67 gtt/min
- B. 20 gtt/min
- C. 25 gtt/min
- D. 50 gtt/min
Correct Answer: B
Rationale: Flow rate = (500 mL 10 gtt/mL) ÷ (5 60) = 5,000 ÷ 300 = 16.67 gtt/min, rounded to 20 gtt/min.
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Long-term monitoring of patients who are taking carbamazepine includes:
- A. Routine troponin levels to assess for cardiac damage
- B. Annual eye examinations to assess for cataract development
- C. Monthly pregnancy tests for all women of childbearing age
- D. Complete blood count every 3 to 4 months
Correct Answer: D
Rationale: CBC monitoring detects carbamazepine-induced blood dyscrasias.
A patient presents in the emergency department with a massive overdose of a drug. The most worrisome signs and symptoms include excessive cardiac stimulation (severe tachycardia, palpitations, angina, etc.). The EDphysician orders IV administration a -adrenergic blocker, saying (correctly) it is the only drug likely to normalize cardiac function quickly and save the patient's life. Which of the following was the most likely drug the patient overdosed on?
- A. A second-generation sulfonylurea (e.g., glipizide, glyburide)
- B. Insulin
- C. Levothyroxine
- D. Prednisone (oral glucocorticoid)
Correct Answer: C
Rationale: Levothyroxine overdose causes thyrotoxicosis, leading to cardiac overstimulation treatable with beta-blockers.
Hypoglycemic effects of repaglinide and nateglinide is determined with:
- A. Closure of ATP sensitive K+ channels
- B. Increase numbers of insulin receptors
- C. Stimulation of PPAR-Y receptors
- D. Degradation of incretin
Correct Answer: A
Rationale: Repaglinide and nateglinide close ATP-sensitive K+ channels on beta cells, triggering insulin release.
Discharge summaries using information technology have several advantages. They can:
- A. Replace the need for oral instruction because the patient has printed material to read at home
- B. Be filed with the patient's chart to document patient teaching
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: B
Rationale: IT discharge summaries document teaching but do not replace oral instructions.
Glucocorticoids causes:
- A. Inhibition of lipolysis
- B. Disposition of fat in upper and lower extremities
- C. Atrophy of fatty tissue on face and paleness
- D. Catabolism of bone tissue
Correct Answer: D
Rationale: Glucocorticoids promote bone catabolism, leading to osteoporosis by inhibiting osteoblast activity and increasing osteoclast activity.