Nokea
Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should be used cautiously in what population:
- A. Older adults
- B. Hypertensive patients
- C. Infants
- D. All of the above
Correct Answer: D
Rationale: Sympathomimetic decongestants like phenylephrine can raise blood pressure or cause adverse effects in older adults, hypertensives, and infants.
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Bisphosphonates treat or prevent osteoporosis by:
- A. Inhibiting osteoclastic activity
- B. Fostering bone resorption
- C. Enhancing calcium uptake in the bone
- D. Strengthening the osteoclastic proton pump
Correct Answer: A
Rationale: Bisphosphonates inhibit osteoclasts, reducing bone resorption; they don't foster resorption or enhance uptake .
Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
- A. OTC drugs are safe and do not cause adverse effects if taken properly.
- B. OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).
- C. OTC drugs are different from any drugs available by prescription and cost less.
- D. OTC drugs could cause serious harm if not taken according to directions.
Correct Answer: D
Rationale: It is important to follow package directions because OTCs are medications that can cause serious harm if not taken properly. OTCs are drugs that have been determined to be safe when taken as directed; however, all drugs can produce adverse effects even when taken properly. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC education should always be included as a part of the hospital discharge instructions.
A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
- A. The impact of the placebo effect on the patients response.
- B. The accumulative effect of the drug if it has been taken for many years.
- C. The impact of the warmer environment on the patients physical status.
- D. Problems with patient compliance with the drug regimen while on vacation.
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and moves to a warmer climate, there is a chance that the patients blood pressure will drop too low, resulting in dizziness and feelings of weakness. Even mild dehydration could exacerbate these effects. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
Which of the following adverse effects of chronic high-dose prednisone administration represents a mineralocorticoid effect?
- A. Buffalo hump
- B. Easy bruising
- C. Edema
- D. Moon facies
Correct Answer: C
Rationale: Edema is a mineralocorticoid effect of prednisone due to sodium and water retention.
Serum digoxin levels are monitored for potential toxicity. Monitoring should occur:
- A. Within 6 hours of the last dose
- B. Because a reference point is needed in adjusting a dose
- C. After three half-lives from the starting of the drug
- D. When a patient has stable renal function
Correct Answer: C
Rationale: Monitoring after three half-lives (steady state) ensures accurate therapeutic levels.