Nokea
A patient presents with a complaint of dark stools and epigastric pain described as gnawing and burning. Which of the medications is the most likely cause?
- A. Acetaminophen
- B. Estradiol
- C. Donepezil
- D. Bethanechol
Correct Answer: D
Rationale: Bethanechol increases gastric acid, potentially causing gastritis or ulcers.
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Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following EXCEPT:
- A. Notify your health-care provider immediately if you have visual change.
- B. Monitor your own blood pressure and pulse daily.
- C. Take a hot shower or bath if you feel dizzy.
- D. Use a sunscreen on exposed body surfaces.
Correct Answer: C
Rationale: Hot showers can worsen amiodarone-induced hypotension, not help it.
A nurse is caring for a patient taking multiple drugs and is concerned about a possible drug-drug interaction. What is the nurse's first and best means of avoiding this problem?
- A. Consult a drug guide.
- B. Call the pharmacist.
- C. Contact the provider.
- D. Ask another nurse.
Correct Answer: A
Rationale: Whenever two or more drugs are being given together, first consult a drug guide for a listing of clinically significant drug-drug interactions. Sometimes problems can be avoided by staggering the administration of the drugs or adjusting their dosages. Consulting the pharmacist is not wrong, but it would not be the first action to take. The nurse holds responsibility for his or her own practice so asking a health care provider or another nurse is based on the assumption that that professional is knowledgeable about all drug-drug interactions, which is likely not the case.
A 57-year-old man was recently diagnosed with Type-2 diabetes mellitus and placed on a medication. He began having myalgias and feeling sick and later developed respiratory distress, so he went to the hospital. His pH was 7.2, and he had elevated blood lactate levels. Which drug is likely causing his problem?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin is associated with lactic acidosis, presenting with low pH and high lactate, especially in overdose or renal impairment.
Which of the following drugs has been shown to restore corticosteroid responsiveness for Bronchial Asthma:
- A. Salbutamol
- B. Sodium cromoglycate
- C. Zifirlukast
- D. Montelukast
Correct Answer: D
Rationale: Montelukast, a leukotriene inhibitor, enhances corticosteroid efficacy in asthma.
Zoster vaccine (Zostavax) is:
- A. A live varicella zoster vaccine from the same strain used to develop the varicella vaccine
- B. Effective in preventing varicella zoster in patients of all ages
- C. Recommended for patients age 40 to 80 who have had chickenpox
- D. Administered at the same time as other live vaccines, as long as they are given the same day
Correct Answer: A
Rationale: Zostavax is a live vaccine from the varicella strain, for adults 50+ (not all ages, B, or 40-80, C); timing with other vaccines has restrictions.