Digoxin levels need to be monitored closely when the following medication is started:
- A. Loratadine
- B. Diphenhydramine
- C. Ipratropium
- D. Albuterol
Correct Answer: D
Rationale: Albuterol , a beta-agonist, can increase digoxin levels by enhancing its effects, requiring close monitoring; antihistamines and ipratropium have minimal impact.
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NSAIDs increase the risk of CNS adverse effects when taken with which group of antibiotics?
- A. Macrolides
- B. Penicillins
- C. Aminoglycosides
- D. Quinolones
Correct Answer: D
Rationale: Quinolones (e.g., ciprofloxacin) with NSAIDs can increase CNS effects like seizures due to GABA inhibition.
A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a pregnancy category B drug. The nurse would inform the patient that:
- A. Adequate studies in pregnant women have demonstrated there is no risk to the fetus.'
- B. Animal studies have not demonstrated a risk to the fetus but there have been no adequate studies in pregnant women.'
- C. Animal studies have shown an adverse effect on the fetus but there are no adequate studies in pregnant women.'
- D. There is evidence of human fetal risk but the potential benefits from use of the drug may be acceptable despite potential risks.'
Correct Answer: B
Rationale: Category B indicates that animal studies have not demonstrated a risk to the fetus but there have been no adequate studies in pregnant women. However, there have not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of pregnancy and no evidence of risk in later trimesters. Category A indicates that adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters. Category C indicates that animal studies have shown an adverse effect on the fetus but there have been no adequate studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the use of the drugs in pregnant women may outweigh the risks.
Potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propylthiouracil. Patients should be taught to report:
- A. Tinnitus and decreased salivation
- B. Fever and sore throat
- C. Hypocalcemia and osteoporosis
- D. Laryngeal edema and difficulty swallowing
Correct Answer: B
Rationale: Fever and sore throat signal granulocytopenia with propylthiouracil; other symptoms are unrelated.
A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which of the following statements is true about this adverse response?
- A. Swelling of the tongue or hoarseness are the most common symptoms.
- B. It appears to be related to the decrease in aldosterone production.
- C. Presence of a dry, hacky cough indicates a high risk for this adverse response.
- D. Because it takes time to build up a blood level, it occurs after being on the drug for about 1 week.
Correct Answer: A
Rationale: Angioedema presents with tongue swelling or hoarseness and is not linked to cough or aldosterone.
Osteoporosis is a major adverse effect caused by the glucocorticoids. It is due to their ability to:
- A. Increase the excretion of calcium
- B. Inhibit absorption of calcium
- C. Stimulate the hypothalamic-pituitary-adrenal axis
- D. Decrease production of prostaglandins
Correct Answer: B
Rationale: Glucocorticoids inhibit calcium absorption in the gut, contributing to osteoporosis.