Nokea
All the following cross placenta except
- A. Warfarin
- B. Heparin
- C. Phenindione
- D. Morphine
Correct Answer: B
Rationale: Heparin, a large molecule, does not cross the placenta; others do.
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When prescribing an opioid analgesic such as acetaminophen and codeine (Tylenol #3), instructions to the patient should include:
- A. The medication may cause sedation and they should not drive.
- B. Constipation is a common side effect and they should increase fluids and fiber.
- C. Patients should not take any other acetaminophen-containing medications at the same time.
- D. All of the above
Correct Answer: D
Rationale: All are critical: sedation, constipation, and acetaminophen overdose risks.
Sally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also takes aspirin four or more times a day for arthritis pain. What are the symptoms of aspirin toxicity for which she would need to be evaluated?
- A. Tinnitus
- B. Diarrhea
- C. Hearing loss
- D. Photosensitivity
Correct Answer: A
Rationale: Tinnitus is an early sign of aspirin toxicity (salicylism); diarrhea or photosensitivity are less specific, and hearing loss is later.
Half-lives of hydrophilic beta-blockers tend to be longer than their lipophilic counterparts.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Hydrophilic beta-blockers (e.g., atenolol) have longer half-lives due to renal elimination, unlike lipophilic ones (e.g., propranolol) metabolized by the liver.
A 66-year-old man is admitted to the hospital with confusion, nausea, and blurred vision. He is currently on digoxin for the treatment of heart failure. On physical exam, his heart rate is 120 bpm. Further evaluation reveals a digoxin level of 5.3 ng/mL (normal range: 0.5-2 ng/mL). The doctor believes his symptoms are due to digoxin toxicity. Which parameter is used to indicate the ability of digoxin to produce the desired effect relative to a toxic effect?
- A. Bioavailability
- B. Efficacy
- C. Intrinsic activity
- D. Therapeutic index
Correct Answer: D
Rationale: Therapeutic index (TI) measures the relative safety of a drug by comparing the dose required for a therapeutic effect to the dose that produces toxicity. In this case, digoxin toxicity is indicated by the elevated level, and TI is the relevant parameter.
A nurse is working as a member of a research team involved in exploring the unique response to drugs each individual displays based on genetic make-up. What is this area of study is called?
- A. Pharmacotherapeutics
- B. Pharmacodynamics
- C. Pharmacoeconomics
- D. Pharmacogenomics
Correct Answer: D
Rationale: Pharmacogenomics is the area of study that includes mapping of the human genome. In the future, medical care and drug regimens may be personally designed based on a patient's unique genetic make-up. Pharmacotherapeutics is the branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. Pharmacodynamics involves how a drug affects the body. Pharmacoeconomics includes the costs involved in drug therapy.