Nokea
All of the following statements concerning drugs which inhibit cholesterol synthesis are true, EXCEPT:
- A. These drugs should not be used in pregnant women or children
- B. These drugs often cause myopathy if used in combination with cyclosporine (Sandimmune)
- C. Failure to discontinue the drug after myopathy has been detected can cause acute renal failure
- D. Several of these drugs tend to lengthen the sleep cycle
Correct Answer: D
Rationale: The correct answer is D. Drugs that inhibit cholesterol synthesis, such as statins, do not tend to lengthen the sleep cycle. Statins are not known to have a direct effect on sleep patterns. Choices A, B, and C are true statements regarding drugs inhibiting cholesterol synthesis. Choice A is correct as these drugs are contraindicated in pregnant women and children due to potential harm to fetal development. Choice B is correct as statins can cause myopathy, especially when used with cyclosporine. Choice C is correct as failure to discontinue the drug after myopathy has been detected can lead to acute renal failure.
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A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which class is likely to be used initially?
- A. Loop diuretics
- B. Osmotic diuretics
- C. Thiazide diuretics
- D. Potassium-sparing diuretics
Correct Answer: C
Rationale: The correct answer is C: Thiazide diuretics. Thiazide diuretics are commonly used as first-line therapy for hypertension due to their effectiveness in reducing blood pressure by promoting diuresis. They work by inhibiting sodium reabsorption in the distal convoluted tubule, leading to decreased fluid volume and lower blood pressure. Thiazides are well-tolerated and have shown to reduce cardiovascular events in hypertensive patients.
Loop diuretics (A) are more potent and are typically reserved for patients with more severe fluid overload conditions. Osmotic diuretics (B) are used for acute renal failure or cerebral edema, not for hypertension. Potassium-sparing diuretics (D) are typically used in combination with thiazides to prevent hypokalemia, not as initial therapy.
A 46-year-old man underwent surgery to remove a glioma of the left brain lobe. An intravenous infusion of a drug was started to induce controlled hypotension to minimize blood loss during surgery. Which of the following drugs would be most appropriate for this purpose?
- A. Labetalol
- B. Hydralazine
- C. Nifedipine
- D. Nitroprusside
Correct Answer: D
Rationale: The correct answer is D: Nitroprusside. Nitroprusside is a potent vasodilator that can rapidly induce controlled hypotension by relaxing smooth muscle in blood vessels. This helps in minimizing blood loss during surgery. Labetalol (A) is a non-selective beta-blocker with alpha-blocking activity, which may not provide rapid hypotension. Hydralazine (B) is a direct vasodilator that can cause reflex tachycardia and may not be as effective in controlled hypotension. Nifedipine (C) is a calcium channel blocker primarily used for hypertension but does not provide rapid hypotension like nitroprusside.
Which statement represents the most appropriate instructions for a patient with a past suicide attempt who is prescribed amitriptyline (Elavil), 150 mg PO at bedtime?
- A. “You will need to pick up your 7-day supply of medication at the pharmacy each week.”
- B. “Your prescription will provide you with a 6-month supply to save you money and time.”
- C. “I’m going to strongly suggest that your spouse dispense this medication to you each evening.”
- D. “Stop by the clinic each evening for your medication so your emotional state of mind can be assessed.”
Correct Answer: A
Rationale: The correct answer is A because picking up a 7-day supply at the pharmacy each week ensures regular monitoring and compliance. This allows healthcare professionals to assess the patient's response to the medication and monitor for any potential side effects or worsening of symptoms. The other choices are incorrect because B does not address the need for regular monitoring, C may not be feasible for all patients and may compromise patient autonomy, and D is impractical and does not provide consistent access to medication.
Indicate the drug belonging to M1-cholinoblockers:
- A. Cimetidine
- B. Ranitidine
- C. Pirenzepin
- D. Omeprazole
Correct Answer: C
Rationale: The correct answer is C: Pirenzepin. M1-cholinoblockers specifically target the M1 muscarinic acetylcholine receptor subtype. Pirenzepin is a selective M1 receptor antagonist, making it the appropriate choice. A: Cimetidine and B: Ranitidine are H2-receptor antagonists used for treating gastric acid-related conditions. D: Omeprazole is a proton pump inhibitor that works by reducing stomach acid production. These drugs do not target the M1 muscarinic receptor subtype, so they are not the correct choices for M1-cholinoblockers.
Indicate the chemical mediator in the antinociceptive descending pathways:
- A. BETA-endorphin
- B. Met- and leu-enkephalin
- C. Dynorphin
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. In the antinociceptive descending pathways, multiple endogenous opioids play a role in pain modulation. Beta-endorphin, met- and leu-enkephalin, and dynorphin all act as chemical mediators to inhibit pain signals. Each of these opioids bind to different opioid receptors in the central nervous system, contributing to the overall analgesic effect. Therefore, the correct answer includes all three options as they collectively participate in the antinociceptive pathways. Choices A, B, and C alone are not sufficient to fully explain the complexity of the pain modulation system, making option D the most comprehensive and accurate choice.