Nokea
Angiotensin-converting enzyme inhibitors are the drug of choice in treating hypertension in diabetic patients because they:
- A. Improve insulin sensitivity
- B. Improve renal hemodynamics
- C. Reduce the production of angiotensin II
- D. All of the above
Correct Answer: D
Rationale: ACE inhibitors benefit diabetics by enhancing insulin sensitivity, protecting kidneys, and blocking angiotensin II.
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A 73-year-old male patient is being discharged home today. The discharge order reads: Take 10 mL of guaifenesin (Robitussin) with plastic measuring caps. How much should the nurse teach the client to take at home?
- A. 1/2 tsp
- B. 1 tsp
- C. 2 tsp
- D. 1 tbsp
Correct Answer: C
Rationale: 10 mL equals 2 teaspoons (1 tsp = 5 mL), the correct household measure for patient teaching.
The nurse is caring for a patient who had a severe, acute, previously unseen adverse effect of a drug in Phase III testing. The patient asks, After all the testing done on this drug, didn't they know this adverse effect could occur? What is the nurse's best response? (Select one that does not apply.)
- A. Pharmaceutical companies sometimes underreport problems to make more money.
- B. Your response to this medication will be reported to the drug company and the Food and Drug Administration (FDA).
- C. After a drug reaches phase III testing it is considered an accepted drug and will not be recalled.
- D. The pharmaceutical company weighs the benefits of the drug with the severity of adverse effects.
Correct Answer: B
Rationale: When a new and unexpected adverse effect occurs, especially one of a serious nature, it is reported to the drug company who reports it to the FDA immediately. When a large number of people begin using the drug in phase III studies, it is not unusual to identify adverse effects not previously noted. It would be both unprofessional and inaccurate to imply that pharmaceutical companies put profit ahead of patient concern because lawsuits would remove any potential profit if a drug proves harmful. The FDA is responsible for weighing risk versus benefit in deciding whether to allow the drug to move to the next phase of testing. Drugs found to have serious adverse effects can be removed from the market at any time.
A nurse is caring for a client who has Depression and a new prescription for Venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply)
- A. Cough
- B. Dizziness
- C. Increased libido
- D. Invention
Correct Answer: B
Rationale: Venlafaxine can cause dizziness , decreased libido , and hypotension ; 'invention' seems a typo.
What is correct concerning TI:
- A. A safer drug has a higher theraputic index
- B. TI might be equal to 1
- C. The more the unwanted adverse effect, the ration decreases
- D. You are in danger if you take 1.8 ng/ml of Digoxin which has the margin of safety (0.8-2)
Correct Answer: A
Rationale: A higher therapeutic index indicates a greater margin of safety between therapeutic and toxic doses, making the drug safer.
Henry presents to clinic with a significantly swollen, painful great toe and is diagnosed with gout. Of the following, which would be the best treatment for Henry?
- A. High-dose colchicine
- B. Low-dose colchicine
- C. High-dose aspirin
- D. Acetaminophen with codeine
Correct Answer: B
Rationale: Low-dose colchicine effectively treats acute gout with fewer side effects than high-dose ; aspirin worsens gout.