Nokea
Daniel has been on 60 mg of prednisone for 10 days to treat a severe asthma exacerbation. It is time to discontinue the prednisone. How is prednisone discontinued?
- A. Patients with asthma are transitioned directly off the prednisone onto inhaled corticosteroids
- B. Prednisone can be abruptly discontinued with no adverse effects
- C. Develop a tapering schedule to slowly wean Daniel off the prednisone
- D. Substitute the prednisone with another anti-inflammatory such as ibuprofen
Correct Answer: C
Rationale: Tapering prevents adrenal suppression after high-dose prednisone; abrupt stop risks crisis.
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Beta blocker which has less first pass metabolism and more excretion through kidney is
- A. Propranolol
- B. Sotalol
- C. Bisprolol
- D. Nadolol
Correct Answer: B
Rationale: Sotalol has minimal first-pass metabolism and is excreted renally.
A nurse is caring for an older adult client in a long-term care facility who has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?
- A. The client will remain 0.1 mg dose, and the dose will be 0.1 mg of 0.1 mg dose, and the dose will be... (truncated)
Correct Answer: A
Rationale: Older adults typically start with a low dose (e.g., 0.025-0.05 mg) of levothyroxine, titrated slowly; 0.1 mg is plausible with adjustment.
Paracetamol is an NSAID with a comparatively low anti-inflammatory effect compared to other NSAIDs.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Paracetamol (acetaminophen) has minimal anti-inflammatory activity, primarily acting as an analgesic and antipyretic.
Which of the following statements about pancreatic enzymes is true?
- A. Dosing may be titrated according to the decrease of steatorrhea
- B. The amount of carbohydrates in the meal drives the amount of enzyme used
- C. The amount of medication used is increased with a cystic fibrosis pulmonary flare
- D. The FDA and Internet-available formulations are bioequivalent
Correct Answer: A
Rationale: Pancreatic enzyme dosing adjusts based on steatorrhea reduction; carbs aren't the driver, and flares don't increase it.
The patient has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a (Rebif). The patient takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per injection. If the patient takes an injection on Monday, how much of the drug would still be in the patient's system when she takes her next injection on Wednesday, assuming the half-life of the drug is 24 hours?
- A. 22 mcg
- B. 16.5 mcg
- C. 11 mcg
- D. 5.5 mcg
Correct Answer: C
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to 1 half the peak level it previously achieved. On Tuesday, there would be 22 mcg remaining in the body, so option A is incorrect. On Wednesday 11 mcg would remain, so option C is the correct answer. At 12 hours before taking the next dose on Wednesday, there would be 16.5 mcg remaining. If the injection were not taken on Wednesday, 12 hours after the dose was due, there would be 5.5 mcg remaining.