Nokea
All the following induce hepatic enzymes except
- A. Rifampicin
- B. Phenytoin
- C. Barbiturates
- D. Tolbutamide
Correct Answer: D
Rationale: Tolbutamide does not significantly induce enzymes; others do.
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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.
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.
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.
The nurse is caring for a client who has a nasogastric tube in place. The client is to receive an oral medication through the tube. Which action by the nurse would be most appropriate? (Select one that does not apply.)
- A. Not diluting liquids prior to administration
- B. Checking the tube for placement
- C. Dissolving crushed tablets in water prior to administration
- D. Flushing the tube with water after drugs are administered
Correct Answer: A
Rationale: Before administration of an oral drug through an NG tube or gastrostomy tube, the nurse should check the tube for placement, dilute and flush liquid drugs through the tube, crush tablets and dissolve them in water before administering them through the tube, and flush the tube with water after the drugs are placed in the tube to clear the tubing completely.
Which of the following diagnostic studies would NOT indicate a problem related to a reductase inhibitor?
- A. Elevated serum transaminase
- B. Increased serum creatinine
- C. Elevated creatinine kinase
- D. Increased white blood cell counts
Correct Answer: D
Rationale: WBC elevation is unrelated to reductase inhibitors; others indicate liver, kidney, or muscle issues.