Nokea
A patient with an edema would have an increased volume of distribution (Vd) if?
- A. The patient was taking an anionic drug
- B. The patient was taking a hydrophobic drug
- C. The patient was taking a hydrophilic drug
- D. An edema always causes an increase in Vd
Correct Answer: C
Rationale: Edema increases extracellular fluid, raising Vd for hydrophilic drugs that distribute into this compartment, not hydrophobic drugs (tissue-bound) or universally.
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A 49-year-old woman with a history of hypertension is treated with spironolactone. She has good blood pressure control and in the last 6 months has shown an improvement in her hirsutism. What is the most likely explanation for these findings?
- A. Androgen receptor inhibition of the hair follicle
- B. Drug toxicity
- C. Hypoaldosteronism
- D. Testosterone levels are elevated
Correct Answer: A
Rationale: Spironolactone's anti-androgenic effects inhibit androgen receptors, reducing hirsutism, alongside its aldosterone antagonism for hypertension.
Which of the following drugs is used for the management of atropine intoxication?
- A. Physostigmine
- B. Neostigmine
- C. Endrophonium
- D. Donepezil
Correct Answer: A
Rationale: Physostigmine, a cholinesterase inhibitor, crosses the BBB to reverse atropine's central effects.
A patient who is taking isoniazid (INH) as part of a two-drug tuberculosis treatment regimen reports tingling of the fingers and toes. The nurse will recommend discussing which treatment with the provider?
- A. Adding pyrazinamide
- B. Changing to ethambutol
- C. Increasing oral fluid intake
- D. Taking pyridoxine (B6)
Correct Answer: D
Rationale: Pyridoxine prevents INH-induced neuropathy (tingling); changing drugs or fluids doesn't address this. Peripheral neuropathy is an adverse reaction to INH, so pyridoxine is usually given to prevent this.
A nurse is providing instructions to a client who has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?
- A. Take the albuterol at the same time each day.
- B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
- C. Use beclomethasone if experiencing an acute episode.
- D. Avoid shaking the beclomethasone before us
Correct Answer: B
Rationale: Albuterol (bronchodilator) should be used before beclomethasone (steroid) to open airways for better steroid delivery.
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.