Nokea
Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
- A. OTC drugs are always safe and will not cause bad effects.'
- B. OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).'
- C. OTC drugs are different from any drugs available by prescription and cost less.'
- D. OTC drugs are thought to be safe when taken as directed.'
Correct Answer: D
Rationale: OTC drugs are drugs that have been determined to be safe when taken as directed. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC education should always be included as a part of the hospital discharge instructions.
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Which of the following drugs used to treat Alzheimer's disease is not an anticholinergic?
- A. Donepezil
- B. Memantine
- C. Rivastigmine
- D. Galantamine
Correct Answer: B
Rationale: Memantine is an NMDA receptor antagonist, not an anticholinesterase like the others.
Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her:
- A. To not abruptly discontinue levetiracetam due to risk for withdrawal seizures
- B. To wear sunscreen due to photosensitivity from levetiracetam
- C. To get an annual eye exam while on levetiracetam
- D. To report weight loss if it occurs
Correct Answer: A
Rationale: Abrupt discontinuation of levetiracetam risks withdrawal seizures.
Mechanisms of transmembrane signaling are the following EXCEPT:
- A. Transmembrane receptors that bind and stimulate a protein tyrosine kinase
- B. Gene replacement by the introduction of a therapeutic gene to correct a genetic effect
- C. Ligand-gated ion channels that can be induced to open or close by binding a ligand
- D. Transmembrane receptor protein that stimulates a GTP-binding signal transducer protein (G-protein) which in turn generates an intracellular second messenger
Correct Answer: B
Rationale: Gene replacement is a therapeutic strategy, not a signaling mechanism.
The choice of diuretic to use in treating hypertension is based on:
- A. Presence of diabetes with loop diuretics being used for these patients
- B. Level of kidney function with a thiazide diuretic being used for an estimated glomerular filtration rate higher than the mid-40 mL/min range
- C. Ethnicity with aldosterone antagonists best for African Americans and older adults
- D. Presence of hyperlipidemia with higher doses needed for patients with LDL above 130 mg/dL
Correct Answer: B
Rationale: Thiazides are effective with GFR >40-50 mL/min; loops are used for lower GFR.
Secobarbital and ethanol when given together show:
- A. Additive sedative action
- B. Reduced sedative action
- C. Competitive antagonism
- D. Chemical antagonism
Correct Answer: A
Rationale: Both secobarbital (barbiturate) and ethanol are CNS depressants, resulting in additive sedation.