Nokea
A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages?
- A. Increased renal secretion
- B. Increased medication-metabolizing enzymes
- C. Liver failure
- D. Peripheral vascular disease
Correct Answer: C
Rationale: Liver failure impairs metabolism, and concurrent use of medications metabolized by the same pathway can increase drug levels, both necessitating lower doses.
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Which of the following is an II generation sulfonylurea drugs, which are used for the treatment of diabetes mellitus type II:
- A. Chlorpropamide
- B. Tolazamide
- C. Tobutamide
- D. Glipizide
Correct Answer: D
Rationale: Glipizide is a second-generation sulfonylurea, more potent and with fewer side effects than first-generation drugs like chlorpropamide.
Competitive antagonists.
- A. Dissociate from receptors faster than their respective agonists
- B. Alter the shape of the log dose response curve of an agonist
- C. According to the rate theory have low dissociation rate constants
- D. Initiate the opposite cellular response to receptor occupancy to that obtained by the agonist
Correct Answer: C
Rationale: Competitive antagonists have low dissociation rates per rate theory, allowing them to block agonists effectively.
Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for to be used for an episode of status epilepticus.
- A. IV phenobarbital
- B. Rectal diazepam (Diastat)
- C. IV phenytoin (Dilantin)
- D. Oral carbamazepine (Tegretol)
Correct Answer: B
Rationale: Rectal diazepam is a rescue medication for status epilepticus at home.
What aspect of pharmacology does a nurse study? (Select one that does not apply.)
- A. Adverse and anticipated drug effects
- B. Molecular pharmacology
- C. Impact of drugs on the body
- D. The body's response to a drug
Correct Answer: B
Rationale: Nurses study pharmacology from a pharmacotherapeutic level, which includes the effect of drugs on the body, the body's response to drugs, and both expected and unexpected drug effects. Chemical and molecular pharmacology (Options A and B) are not included in nursing pharmacology courses.
The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day. If this is done:
- A. The initial dose of glargine is reduced by 20% to avoid hypoglycemia
- B. The initial dose of glargine is 2 to 10 units per day
- C. Patients who have been on high doses of NPH will need tests for insulin antibodies
- D. Obese patients may require more than 100 units per day
Correct Answer: A
Rationale: Switching to glargine reduces the dose by 20% to prevent hypoglycemia due to its steady action vs. NPH peaks.