Nokea
Digoxin is a drug that has been used to treat systolic heart failure for over 200 years. It has a therapeutic index value of 2. How many daily doses of digoxin will the average patient have to take at one time to have a 50:50 chance of developing toxic side effects?
- A. One
- B. Two
- C. I don't know
Correct Answer: B
Rationale: With a therapeutic index of 2, the toxic dose is twice the therapeutic dose. Taking two daily doses at once would reach this threshold, giving a 50:50 chance of toxicity.
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A nurse is caring for a client who takes Paroxetine to treat PTSD and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions to manage Bruxism? (Select all that apply.)
- A. Concurrent administration of buspirone
- B. Administration of a different SSRI
- C. Use of a mouth guard
- D. Changing to a different class of antidepressant medication
Correct Answer: C
Rationale: A mouth guard is a practical intervention for bruxism; medication changes may not address it directly.
An agonist is substance that:
- A. Interacts with the receptor without producing any effect
- B. Interacts with the receptor and initiates changes in cell function, producing various effects
- C. Increases concentration of another substance to produce effect
- D. Interacts with plasma proteins and doesn't produce any effect
Correct Answer: B
Rationale: An agonist binds receptors and activates them, producing a biological effect.
Glucocorticoids causes:
- A. Inhibition of lipolysis
- B. Disposition of fat in upper and lower extremities
- C. Atrophy of fatty tissue on face and paleness
- D. Catabolism of bone tissue
Correct Answer: D
Rationale: Glucocorticoids promote bone catabolism, leading to osteoporosis by inhibiting osteoblast activity and increasing osteoclast activity.
Protein binding of a drug helps in
- A. Distribution
- B. Prolonging half life
- C. Limiting metabolism
- D. All of the above
Correct Answer: D
Rationale: Protein binding affects distribution (bound drugs stay in plasma), prolongs half-life (less free drug available for clearance), and limits metabolism (bound drug is less accessible to enzymes).
The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client:
- A. To take aspirin (acetylsalicylic acid) as needed for headache
- B. Drink beverages containing alcohol in moderate amounts each evening
- C. Consult with health care providers (HCPs) before receiving immunizations
- D. That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair
Correct Answer: C
Rationale: Because antineoplastic medications lower the resistance of the body, clients must be informed not to receive immunizations without a HCP's approval. Clients also need to avoid contact with individuals who have recently received a live virus vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side effects.