A patient with Cushing's syndrome is being treated by X-irradiation of the pituitary. It may take several months of treatment for adequate symptomatic and metabolic improvement. Until that time, which of the following might be administered adjunctively to suppress glucocorticoid synthesis?
- A. Cimetidine
- B. Cortisol (massive doses)
- C. Fludrocortisone
- D. Ketoconazole
Correct Answer: D
Rationale: Ketoconazole inhibits adrenal steroidogenesis, reducing glucocorticoid levels in Cushing's syndrome.
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A nurse working in radiology administers iodine to a patient who is having a computed tomography (CT) scan. The nurse working on the oncology unit administers chemotherapy to patients who have cancer. At the Public Health Department, a nurse administers a measles-mumps-rubella (MMR) vaccine to a 14-month-old child as a routine immunization. Which branch of pharmacology best describes the actions of all three nurses?
- A. Pharmacoeconomics
- B. Pharmacotherapeutics
- C. Pharmacodynamics
- D. Pharmacokinetics
Correct Answer: B
Rationale: Pharmacology is the study of the biologic effects of chemicals. Nurses are involved with clinical pharmacology or pharmacotherapeutics, which is a branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. The radiology nurse is administering a drug to help diagnose a disease. The oncology nurse is administering a drug to help treat a disease. Pharmacoeconomics includes any costs involved in drug therapy. Pharmacodynamics involves how a drug affects the body and pharmacokinetics is how the body acts on the body.
A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient?
- A. Noncompliance: Cost of the drug
- B. Deficient knowledge: Unfamiliar with drug therapy
- C. Risk for injury: Related to adverse effects of the drug
- D. Ineffective health maintenance: Need for medication
Correct Answer: C
Rationale: Sedation increases the risk of falls or injury, making 'Risk for injury' the priority diagnosis over knowledge deficits or compliance issues.
Which of the following vitamin or mineral supplements may by teratogenic if a pregnant woman takes more than the recommended amount?
- A. Iron
- B. Vitamin A
- C. Vitamin B6
- D. Vitamin C
Correct Answer: B
Rationale: Excess vitamin A (retinol) is teratogenic, potentially causing congenital malformations.
Patients with pernicious anemia require treatment with:
- A. Iron
- B. Folic acid
- C. Epogen alpha
- D. Vitamin B12
Correct Answer: D
Rationale: Pernicious anemia requires vitamin B12 due to absorption deficiency; folate masks it without correcting neuropathy.
Jacob has hypertension, for which a calcium channel blocker has been prescribed. This drug helps control blood pressure because it:
- A. Decreases the amount of calcium inside the cell
- B. Reduces stroke volume
- C. Increases the activity of the Na+/K+/ATPase pump indirectly
- D. Decreases heart rate
Correct Answer: A
Rationale: Calcium channel blockers reduce intracellular calcium, relaxing vascular smooth muscle.