Nokea
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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Low doses of aspirin prolong bleeding time by selectively inhibiting synthesis of the following mediator in the platelets:
- A. Thromboxane Aâ‚‚
- B. 5-Hydroxytryptamine
- C. Platelet activating factor
- D. Prostacyclin
Correct Answer: A
Rationale: Low-dose aspirin irreversibly inhibits COX-1 in platelets, reducing thromboxane Aâ‚‚ production, which promotes platelet aggregation, thus prolonging bleeding time.
A patient on a Class IV antiarrhythmic is experiencing bradycardia. Which medication is the patient most likely taking?
- A. Amiodarone
- B. Diltiazem
- C. Flecainide
- D. Lidocaine
Correct Answer: B
Rationale: Diltiazem, a Class IV calcium channel blocker, slows AV node conduction, commonly causing bradycardia.
Which of the following avoids first pass effect of drugs
- A. Oral ingestion
- B. Rectal Suppository
- C. Intra venous injection
- D. Intra-arterial injection
Correct Answer: D
Rationale: Intra-arterial injection bypasses the liver, avoiding first-pass metabolism.
Which of the following statements CORRECTLY describes the mechanism of action of imatinib mesylate in chronic myeloid leukemia:
- A. Inhibitor of tyrosine kinase
- B. Inhibitor of topoisomerase 1
- C. Inhibitor of topoisomerase 2
- D. It is an alkylating agent
Correct Answer: A
Rationale: Imatinib inhibits BCR-ABL tyrosine kinase in CML.
A nurse is caring for an older adult client in a long-term care facility who has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?
- A. The client will remain 0.1 mg dose, and the dose will be 0.1 mg of 0.1 mg dose, and the dose will be... (truncated)
Correct Answer: A
Rationale: Older adults typically start with a low dose (e.g., 0.025-0.05 mg) of levothyroxine, titrated slowly; 0.1 mg is plausible with adjustment.