Nokea
Despite good blood pressure control, an NP might change a patient's drug from an angiotensin-converting enzyme (ACE) inhibitor to an angiotensin II receptor blocker (ARB) because the ARB:
- A. Is stronger than the ACE inhibitor
- B. Does not produce a dry, hacky cough
- C. Has no effect on the renal system
- D. Reduces sodium and water retention
Correct Answer: B
Rationale: ARBs lack the cough side effect common with ACE inhibitors.
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When melatonin is used to induce sleep, the recommendation is that the patient:
- A. Take 10 mg 30 minutes before bed nightly
- B. Take 1 to 5 mg 30 minutes before bed nightly
- C. Not take melatonin more than three nights a week
- D. Combine melatonin with zolpidem (Ambien) for the greatest impact on sleep
Correct Answer: B
Rationale: 1-5 mg of melatonin 30 minutes before bed is the recommended dose for sleep induction.
While providing medications to clients on the cardiac unit, the nurse anticipates that hydralazine hydrochloride and isosorbide dinitrate (BiDil) would most likely be prescribed for which of the following clients?
- A. A 48-year-old Caucasian male diagnosed with atrial fibrillation
- B. A 55-year-old African American female diagnosed with hypertension
- C. A 63-year-old Caucasian female diagnosed with sick sinus syndrome
- D. A 64-year-old African American male diagnosed with heart failure
Correct Answer: D
Rationale: BiDil (hydralazine/isosorbide) is FDA-approved specifically for heart failure in African Americans , showing improved outcomes in this population.
What does the lipid solubility of the drug influence?
- A. Absorption of the drug
- B. Metabolism of the drug
- C. Excretion of the drug
- D. Distribution of the drug
Correct Answer: D
Rationale: Factors that can affect distribution include the drug's lipid solubility and ionization and the perfusion of the reactive tissue. The lipid solubility of a drug does not influence absorption, metabolism, or excretion.
Taking which drug with food maximizes it bioavailability?
- A. Donepezil
- B. Galantamine
- C. Rivastigmine
- D. Memantine
Correct Answer: C
Rationale: Rivastigmine's bioavailability is maximized with food, reducing GI side effects.
The nurse is counseling a patient who wants to stop smoking. Which statement by the nurse is correct?
- A. Bupropion (Zyban) is effective and does not have serious adverse effects
- B. Nicotine replacement therapies are effective and eliminate the need for behavioral therapy
- C. Varenicline (Chantix) may be used short-term for 1 to 2 months
- D. You may experience headaches and increased appetite for several months after stopping smoking
Correct Answer: D
Rationale: Headaches and appetite increase are common nicotine withdrawal symptoms; bupropion has side effects, and varenicline is longer-term. Headaches and increased appetite are common during nicotine withdrawal and may last for several months.