Nokea
A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy?
- A. Pallative therapy
- B. Maintenance therapy
- C. Empirric therapy
- D. Supplmental therapy
Correct Answer: A
Rationale: The goal of palliative therapy is to make the patient as comfortable as possible. It is typically used in the end stages of illnesses when all attempts at curative therapy have failed. Maintenance therapy is used for the treatment of chronic illnesses such as hypertension. Empirric therapy is based on clinical probabilities and involves drug administration when a certain pathologic condition has an uncertain but high likelihood of occurrence based on the patient's initial presenting symptoms. Supplemental therapy (or replacement therapy) supplies the body with a substance needed to maintain normal function.
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The nurse will be injecting a drug into the superficial skin layers immediately underneath the epidermal layer of skin. Which route does this describe?
- A. Intradermal
- B. Subcutaneous
- C. Intramuscular
- D. Transdermal
Correct Answer: A
Rationale: Injections under the more superficial skin layers immediately underneath the epidermal layer of skin and into the dermal layer are known as intradermal injections. Injections into the fatty subcutaneous tissue under the dermal layer of skin are referred to as subcutaneous injections. Injections into the muscle beneath the subcutaneous fatty tissue are referred to as intramuscular injections. Transdermal drugs are applied to the skin via an adhesive patch.
The patient is receiving two different drugs. At current dosages and dosage forms, both drugs have the same concentration of the active ingredient. Which term is used to identify this principle?
- A. Bioequivalent
- B. Synergistic
- C. Proddrugs
- D. Steady state
Correct Answer: A
Rationale: Two drugs absorbed into the circulation in the same amount (in specific dosage forms) have the same bioavailability; thus, they are bioequivalent. A drug's steady state is the physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed from each dose. The term synergistic refers to two drugs, given together, with a resulting effect that is greater than the sum of the effects of each drug given alone. A prodrug is an inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body.
When given an intravenous medication, the patient says to the nurse, -I usually take pills. Why does this medication have to be given in the arm? What is the nurse's best answer?
- A. The medication will cause fewer adverse effects when given intravenously.
- B. The intravenous medication will have delayed absorption into the body's tissues.
- C. The action of the medication will begin sooner when given intravenously.
- D. There is a lower chance of allergic reactions when drugs are given intravenously.
Correct Answer: C
Rationale: An intravenous (IV) injection provides the fastest route of absorption. The IV route does not affect the number of adverse effects, nor does it cause delayed tissue absorption (it results in faster absorption). The IV route does not affect the number of allergic reactions.
The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?
- A. Parenteral drugs bypass the first-pass effect.
- B. Absorption of parenteral drugs is affected by reduced blood flow to the stomach.
- C. Absorption of parenteral drugs is faster when the stomach is empty.
- D. Parenteral drugs exert their effects while circulating in the bloodstream.
Correct Answer: A
Rationale: Drugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to the stomach and the presence of food in the stomach apply to enteral drugs (taken orally), not to parenteral drugs. Parenteral drugs must be absorbed into cells and tissues from the circulation before they can exert their effects; they do not exert their effects while circulating in the bloodstream.
When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication, that is not highly protein bound?
- A. Renal excretion will be faster.
- B. The drug will be metabolized quickly.
- C. The duration of action of the medication will be shorter.
- D. The duration of action of the medication will be longer.
Correct Answer: D
Rationale: Drugs that are bound to plasma proteins are characterized by longer duration of action. Protein binding does not make renal excretion faster, does not speed up drug metabolism, and does not cause the duration of action to be shorter.