Nokea
All of the following are protein bound except:
- A. Propranolol
- B. Atenolol
- C. Phenylbutazone
- D. Warfarin
Correct Answer: B
Rationale: Atenolol has low protein binding; others bind extensively.
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Pentobarbitone is
- A. Long acting barbiturates
- B. Short acting barbiturates
- C. Ultra short acting barbiturates
- D. Intermediate acting barbiturates
Correct Answer: D
Rationale: Pentobarbitone (pentobarbital) is classified as an intermediate-acting barbiturate, with a duration of action between short-acting and long-acting barbiturates.
John has clonidine, a centrally acting adrenergic blocker, prescribed for his hypertension. He should:
- A. Not miss a dose or stop taking the drug because of potential rebound hypertension
- B. Increase fiber in the diet to treat any diarrhea that may occur
- C. Reduce fluid intake to less than 2 liters per day to prevent fluid retention
- D. Avoid sitting for long periods, as this can lead to deep vein thrombosis
Correct Answer: A
Rationale: Clonidine withdrawal can cause rebound hypertension, making adherence critical.
Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
- A. OTC drugs are safe and do not cause adverse effects if taken properly.
- B. OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).
- C. OTC drugs are different from any drugs available by prescription and cost less.
- D. OTC drugs could cause serious harm if not taken according to directions.
Correct Answer: D
Rationale: It is important to follow package directions because OTCs are medications that can cause serious harm if not taken properly. OTCs are drugs that have been determined to be safe when taken as directed; however, all drugs can produce adverse effects even when taken properly. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC education should always be included as a part of the hospital discharge instructions.
A 57-year-old man was recently diagnosed with Type-2 diabetes mellitus and placed on a medication. He began having myalgias and feeling sick and later developed respiratory distress, so he went to the hospital. His pH was 7.2, and he had elevated blood lactate levels. Which drug is likely causing his problem?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin can cause lactic acidosis, a rare but serious side effect, presenting with low pH and elevated lactate levels.
A nurse is teaching an adolescent client who has a new prescription for Clomipramine for OCD. Which of the following instructions should the nurse include to minimize an adverse effect of his medication?
- A. Wear sunglasses when outdoors.
- B. Check your temperature daily.
- C. Take this medication in the morning.
- D. Add extra calories to your die
Correct Answer: A
Rationale: Clomipramine can cause photosensitivity; sunglasses minimize this adverse effect.