Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and lack of motivation. An appropriate initial antidepressant for her would be:
- A. Fluoxetine (Prozac)
- B. Paroxetine (Paxil)
- C. Amitriptyline (Elavil)
- D. Duloxetine (Cymbalta)
Correct Answer: D
Rationale: Duloxetine addresses both depression and fatigue, unlike sedating options.
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Which of the following antidiabetic agents acts on the peroxisome proliferator-activated receptor-gamma (PPAR-gamma) nuclear receptor?
- A. acarbose
- B. glyburide
- C. insulin lispro
- D. pioglitazone
Correct Answer: D
Rationale: Pioglitazone is a thiazolidinedione that activates PPAR-gamma, enhancing insulin sensitivity in peripheral tissues.
First-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they are:
- A. More effective than first-generation antihistamines
- B. Less sedating than the first-generation antihistamines
- C. Prescription products, therefore are covered by insurance
- D. Able to be taken with central nervous system (CNS) sedatives, such as alcohol
Correct Answer: B
Rationale: Loratadine is a second-generation antihistamine, less sedating than first-generation ones; it's not more effective , insurance-driven , or safe with sedatives .
Etidronate is prescribed for a postmenopausal woman who is at great risk for developing osteoporosis. Which of the following adverse effects to this drug is the patient most likely to experience?
- A. Tetany
- B. Cholelithiasis
- C. Esophagitis
- D. Renal damage from calcium stone formation
Correct Answer: C
Rationale: Bisphosphonates like etidronate commonly cause esophagitis if not taken properly.
A patient who has a long history of alcohol abuse is admitted to the hospital for detoxification. In addition to medications needed to treat withdrawal symptoms, the nurse will anticipate giving intravenous
- A. dopamine to restore blood pressure
- B. fluid boluses to treat dehydration
- C. glucose to prevent hypoglycemia
- D. thiamine to treat nutritional deficiency
Correct Answer: D
Rationale: Thiamine prevents Wernicke's encephalopathy in alcohol detox; glucose follows if needed. Thiamine should be given to prevent Wernicke's encephalopathy in patients treated for alcoholism.
Which of the following statements is correct regarding insulin glargine?
- A. It is primarily used to control postprandial hyperglycemia
- B. It is a 'peakless' insulin
- C. The prolonged duration of activity is due to slow dissociation from albumin
- D. It should not be used in a regimen with insulin lispro or glulisine
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin providing steady glucose control.