A patient was treated with digoxin and he develop signs and symptoms of * digoxin toxicity caused by furosemide therapy. What did the diuretic most likely do to precipitate the digoxin toxicityy?
- A. caused by hypocalcemia
- B. caused by hypo natremia
- C. caused by hypokalemia
- D. None of the above
Correct Answer: C
Rationale: The correct answer is C: caused by hypokalemia. Furosemide, a loop diuretic, can lead to potassium loss (hypokalemia), which can exacerbate digoxin toxicity. Low potassium levels increase the risk of digoxin binding more strongly to cardiac tissue, leading to toxicity symptoms. Hypocalcemia (A) and hyponatremia (B) are not directly related to digoxin toxicity, making them incorrect choices. Choice D is incorrect as hypokalemia is a known risk factor for digoxin toxicity.
You may also like to solve these questions
While managing a client after a medical or surgical procedure for bladder stones, when should the nurse notify the physician?
- A. Assessment of sexual habits
- B. Assessment and recognition of abnormal findings
- C. Assessment of allergies to seafood
- D. Assessment of insurance coverage
Correct Answer: B
Rationale: The correct answer is B because assessing and recognizing abnormal findings is crucial in post-procedure care for bladder stones. This includes monitoring for signs of infection, urinary retention, bleeding, or other complications that may require immediate medical intervention. Notifying the physician promptly allows for timely treatment and prevents potential complications. Choices A, C, and D are incorrect as they are not directly related to the immediate post-procedure care for bladder stones and do not require immediate physician notification.
Which of the following drug which directly inhibits HIV-reverse transcriptase * without the need for intracellular activation by phosphorylation:
- A. Nelnavir
- B. Nevirapine
- C. Stavudine
- D. Didanosine
Correct Answer: B
Rationale: The correct answer is B: Nevirapine. Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that directly inhibits HIV-reverse transcriptase without needing intracellular activation. It binds directly to the enzyme's active site, preventing the conversion of viral RNA to DNA.
Rationale:
1. Nelnavir (A) is a protease inhibitor that works by blocking the protease enzyme needed for viral replication, not reverse transcriptase inhibition.
2. Stavudine (C) and Didanosine (D) are nucleoside reverse transcriptase inhibitors (NRTIs) that require intracellular phosphorylation to become active, unlike Nevirapine.
In summary, Nevirapine is the correct answer as it directly inhibits HIV-reverse transcriptase without needing intracellular activation, distinguishing it from the other choices which belong to different drug classes or require intracellular phosphorylation.
Clavulanic acid is combined with amoxicillin because: *
- A. It inhibits beta lactamases that destroy amoxicillin
- B. It prevents renal excretion of amoxicillin
- C. It destroy bacteria that are not destroyed by amoxicillin
- D. It counteracts the adverse effects of amoxicillin
Correct Answer: A
Rationale: The correct answer is A because clavulanic acid acts as a beta-lactamase inhibitor, protecting amoxicillin from being destroyed by beta-lactamase enzymes produced by bacteria. This allows amoxicillin to effectively kill the bacteria. Choices B, C, and D are incorrect because clavulanic acid does not prevent renal excretion of amoxicillin, destroy bacteria directly, or counteract adverse effects of amoxicillin. The primary purpose of combining clavulanic acid with amoxicillin is to enhance amoxicillin's effectiveness by preventing its degradation by bacterial enzymes.
A 35 year old man presents to the ER with severe headache. After lab workup, patient is diagnosed to have increased intracranial pressure. Which diuretic would work best to reduce this pressure?
- A. Hydrochlorothiazide
- B. Mannitol
- C. Acetazolamide
- D. Furosemide
Correct Answer: B
Rationale: The correct answer is B: Mannitol. Mannitol is an osmotic diuretic that works by drawing fluid out of brain tissue and reducing intracranial pressure. It is commonly used in cases of increased intracranial pressure due to its ability to easily cross the blood-brain barrier and reduce cerebral edema. Hydrochlorothiazide (A) is a thiazide diuretic mainly used for hypertension and not effective for this condition. Acetazolamide (C) is a carbonic anhydrase inhibitor that can reduce CSF production but is not as effective as mannitol for rapid reduction of intracranial pressure. Furosemide (D) is a loop diuretic that primarily acts on the kidneys and is not as effective as mannitol for reducing intracranial pressure.
Which of the following best describes the mechanism of action of alprostadil?
- A. Alprostadil increases cAMP
- B. Alprostadil increases cGMP
- C. Alprostadil increases PDE-5
- D. Alprostadil blocks NO (nitric oxide)
Correct Answer: A
Rationale: Alprostadil is a prostaglandin E1 analog that works by binding to specific receptors and activating adenylate cyclase, leading to increased levels of cAMP. This results in smooth muscle relaxation and vasodilation. Therefore, choice A is correct. Choices B and C are incorrect as alprostadil does not directly affect cGMP levels or PDE-5 activity. Choice D is also incorrect as alprostadil does not block nitric oxide, but rather enhances its effects through the cAMP pathway.