Nokea
Carbamazepine has a Black Box Warning recommending testing for the HLA-B*1502 allele in patients with Asian ancestry prior to starting therapy due to:
- A. Decreased effectiveness of carbamazepine in treating seizures in Asian patients with HLA-B*1502 allele
- B. Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
- C. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 allele
- D. Patients who have the HLA-B*1502 allele being more likely to have a resistance to carbamazepine
Correct Answer: C
Rationale: HLA-B*1502 in Asians increases Stevens-Johnson syndrome risk with carbamazepine , per FDA warning, not efficacy or interactions .
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An agonist is substance that:
- A. Interacts with the receptor without producing any effect
- B. Interacts with the receptor and initiates changes in cell function, producing various effects
- C. Increases concentration of another substance to produce effect
- D. Interacts with plasma proteins and doesn't produce any effect
Correct Answer: B
Rationale: An agonist binds receptors and activates them, producing a biological effect.
The nurse observes that after administration of a drug the patient has developed itching and a skin rash. The nurse interprets these findings as which of the following?
- A. Toxicity
- B. Allergic reaction
- C. Angioedema
- D. Crystalluria
Correct Answer: B
Rationale: Allergic reactions are manifested by a variety of signs and symptoms including itching, skin rashes, and hives. Swollen eyelids, lips, and mouth are some of the symptoms of angioedema, an allergic drug reaction that may block the airway, causing asphyxia. Toxicity or toxic reactions are caused when blood concentration levels exceed the therapeutic level of drugs. Reduced blood pressure is called hypotension. Crystals in the urine are symptoms of crystalluria.
A good history of herb and supplement use is critical before prescribing because approximately % of patients in the United States are using herbal products.
- A. 10
- B. 5
- C. 38
- D. 70
Correct Answer: C
Rationale: Approximately 38% of U.S. patients use herbal products, necessitating a thorough history.
A physician has ordered intramuscular injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug, therefore, morphine is categorized as a:
- A. Schedule I drug
- B. Schedule II drug
- C. Schedule III drug
- D. Schedule IV drug
Correct Answer: B
Rationale: Narcotics such as morphine are considered schedule II drugs because of the high abuse potential with severe dependence liability. Schedule I drugs have high abuse potential and no accepted medical use. Schedule III drugs have a lesser abuse potential than schedule II drugs and an accepted medical use. Schedule IV drugs have low abuse potential and limited dependence liability.
Carvedilol is heavily metabolized by CYP2D6 and 2C9, resulting in drug interactions with which of the following drug classes?
- A. Histamine 2 blockers
- B. Quinolones
- C. Serotonin re-uptake inhibitors
- D. All of the above
Correct Answer: C
Rationale: SSRIs inhibit CYP2D6, increasing carvedilol levels and effects.