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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Carbamazepine has a Black Box Warning recommending testing for the HLA-B*1502 allele in patients with Asian ancestry prior to starting therapy due to:
- A. Decreased effectiveness of carbamazepine in treating seizures in Asian patients with HLA-B*1502 allele
- B. Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
- C. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 allele
- D. Patients who have the HLA-B*1502 allele being more likely to have a resistance to carbamazepine
Correct Answer: C
Rationale: HLA-B*1502 in Asians increases Stevens-Johnson syndrome risk with carbamazepine , per FDA warning, not efficacy or interactions .
A patient needs 500 mL of an infusion over 5 hours. The drop factor is 10 gtt/mL. Calculate the flow rate in drops per minute.
- A. 16.67 gtt/min
- B. 20 gtt/min
- C. 25 gtt/min
- D. 50 gtt/min
Correct Answer: B
Rationale: Flow rate = (500 mL 10 gtt/mL) ÷ (5 60) = 5,000 ÷ 300 = 16.67 gtt/min, rounded to 20 gtt/min.
A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should anticipate administering which of the following medications?
- A. Phenytoin
- B. Ethosuximide
- C. Gabapentin
- D. Carbamazepine
Correct Answer: B
Rationale: Ethosuximide , valproic acid , and lamotrigine are effective for absence seizures.
A patient is diagnosed with tinea capitis. The provider will order which systemic antifungal medication for this patient?
- A. Anidulafungin (Eraxis)
- B. Fluconazole (Diflucan)
- C. Griseofulvin (Fulvicin)
- D. Ketoconazole (Nizoral)
Correct Answer: C
Rationale: Griseofulvin treats tinea capitis systemically; fluconazole or ketoconazole are less specific. Griseofulvin is used to treat tinea capitis.
The major disadvantage of celecoxib is:
- A. It is less efficacious compared to non-selective cox-1 inhibitors
- B. It causes more gastrointestinal disturbances
- C. It increases cardiovascular risk of death
- D. It increases risk of kidney disease
Correct Answer: C
Rationale: Celecoxib, a COX-2 inhibitor, increases cardiovascular risk.