Clinical dosing of Bethanechol:
- A. Begins at the highest effective dose to obtain a rapid response
- B. Starts at 5 mg to 10 mg PO and is repeated every hour until a satisfactory clinical response is achieved
- C. Requires dosing only once daily
- D. Is the same for both the oral and parenteral route
Correct Answer: B
Rationale: Bethanechol is titrated hourly from 5-10 mg to achieve the desired effect.
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Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to:
- A. Increase DNA and RNA synthesis.
- B. Promote the biosynthesis of nucleic acids.
- C. Increase estrogen concentration and estrogen response.
- D. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.
Correct Answer: D
Rationale: Tamoxifen is an antineoplastic medication that competes with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Tamoxifen is used to treat metastatic breast carcinoma in women and men. Tamoxifen is also effective in delaying the recurrence of cancer following mastectomy. Tamoxifen reduces DNA synthesis and estrogen response.
The following are recognized effects of propranolol except
- A. Increases microcoronary blood flow
- B. Decrease in heart rate
- C. Decrease in cardiac output
- D. Reduction in ventricular systolic pressure
Correct Answer: A
Rationale: Propranolol reduces coronary flow; other effects are correct.
antagonist is a substance that:
- A. Binds to the receptors and initiates changes in cell function, producing maximal effect
- B. Binds to the receptors and initiates changes in cell function, producing submaximal effect
- C. Interacts with plasma proteins and doesn't produce any effect
- D. Binds to the receptors without directly altering their functions
Correct Answer: D
Rationale: An antagonist binds receptors without activating them, blocking agonist effects.
Angina is caused by:
- A. Blocking beta1 receptors with a constant binding of noradrenaline
- B. Activating beta2 receptors
- C. Beta1 receptors are not active anymore
- D. Extreme binding of noradrenaline due to up regulation
Correct Answer: D
Rationale: Angina results from myocardial ischemia, often due to excessive demand or reduced supply, which can be exacerbated by upregulated noradrenaline binding increasing heart workload.
Which of the following drugs do not cross the placenta
- A. Dilantin
- B. Diazepam
- C. Acinocoumarin
- D. Heparin
Correct Answer: D
Rationale: Heparin does not cross the placenta due to its large size.