Nokea
Administration of sulfonamide may intensify the action of tolbutamide, through:
- A. Activation of the islets of pancreas
- B. Direct action on the utilization of glucose
- C. Synergistic action
- D. Competing with tolbutamide in plasma protein binding
Correct Answer: D
Rationale: Sulfonamides displace tolbutamide from plasma proteins, increasing free drug levels and enhancing its hypoglycemic effect.
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A patient is considering using herbal supplements and asks the nurse about them. Which response by the nurse would be most appropriate?
- A. Herbal supplements are safe to use because they are regulated closely.'
- B. Herbal supplements can affect the way other medications will act.'
- C. Taking more than the recommended amount usually is not harmful because they are natural.'
- D. The risk of the supplement interacting with any prescription medications is extremely low.'
Correct Answer: B
Rationale: The nurse needs to explain to the patient that just because an herbal supplement is labeled 'natural' does not mean the supplement is safe or without harmful effects. Herbal supplements can act the same way as drugs and can cause medical problems if not used correctly or if taken in large amounts. Herbal supplements are not regulated by the FDA, so products lack standardization in relation to purity and potency. In addition, the patient should be warned not to take more than the recommended dose of any herbal health product or supplement. The problems that these products can cause are much more likely to occur if the patient takes too much or takes them for too long.
Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?
- A. Betamethasone, an inhaled corticosteroid
- B. Salmeterol, an inhaled long-acting beta-agonist
- C. Albuterol, a short-acting beta-agonist
- D. Montelukast, a leukotriene modifier
Correct Answer: B
Rationale: Salmeterol carries a Black Box Warning for increased asthma-related deaths, especially in African Americans, requiring caution; others are safer.
Persistent dry cough is a common side effect of:
- A. ACE inhibitor
- B. Calcium channel blockers
- C. Beta blockers
- D. Angiotensin receptor blockers
Correct Answer: A
Rationale: ACE inhibitors, such as lisinopril, frequently cause a persistent dry cough due to increased bradykinin levels irritating the respiratory tract.
Which of the following is not an indication that growth hormone supplements should be discontinued?
- A. Imaging indication of epiphyseal closure
- B. Growth curve increases have plateaued
- C. Complaints of mild bone pain
- D. Achievement of anticipated height goals
Correct Answer: C
Rationale: Mild bone pain is a common side effect of growth hormone, not a stop signal; closure or plateau are.
A nursing student is preparing to administer a prescribed drug to a patient. The student reviews information about the drug and its actions. Which of the following would be the best choice for obtaining this information?
- A. Nursing instructor
- B. Nurse assigned to the patient
- C. Clinical drug reference
- D. Prescribing health care provider
Correct Answer: C
Rationale: Although the nursing student can ask the nursing instructor, the nurse assigned to the patient, and the prescribing health care provider for information about the drug, the best choices for drug information would include an appropriate drug reference and the clinical pharmacist.