Nokea
Drugs significantly affected by enzyme induction include the following except:
- A. Barbiturate
- B. Chlorpromazine
- C. Diphenyl hydantoin
- D. Warfarin
Correct Answer: B
Rationale: Barbiturates, phenytoin (diphenyl hydantoin), and warfarin are affected by enzyme induction; chlorpromazine is less so.
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Which of the following regarding E max is correct?
- A. E max assumes that as long as you increase the concentration of the drug, there will be a higher effect of the drug
- B. E max is used to compare the potency of different drugs
- C. E max assumes that all receptors are occupied by the drug and no increase in response is observed if a higher concentration of drug is obtained
- D. All of the previous points are incorrect
Correct Answer: C
Rationale: Emax is the maximal effect when all receptors are occupied; further dose increases yield no additional effect.
Which of the following adverse effects are less likely in a beta1-selective blocker?
- A. Dysrhythmias
- B. Impaired insulin release
- C. Reflex orthostatic changes
- D. Decreased triglycerides and cholesterol
Correct Answer: B
Rationale: Beta1-selective blockers (e.g., atenolol) have less impact on insulin release compared to non-selective blockers.
A 57-year-old man was recently diagnosed with Type-2 diabetes mellitus and placed on a medication. He began having myalgias and feeling sick and later developed respiratory distress, so he went to the hospital. His pH was 7.2, and he had elevated blood lactate levels. Which drug is likely causing his problem?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin is associated with lactic acidosis, presenting with low pH and high lactate, especially in overdose or renal impairment.
Kenneth is taking warfarin and is asking about what he can take for minor aches and pains. The best recommendation is:
- A. Ibuprofen 400 mg three times a day
- B. Acetaminophen, not to exceed 4 grams per day
- C. Prescribe acetaminophen with codeine
- D. Aspirin 640 mg three times a day
Correct Answer: B
Rationale: Acetaminophen is safest with warfarin, avoiding bleeding risks from ibuprofen or aspirin ; codeine is unnecessary for minor pain.
A nurse is assessing a client after administering a prescribed medication. Which of the following would alert the nurse to suspect that the client is developing anaphylactic shock?Select one that does not apply.
- A. Wheezing
- B. Hypertension
- C. Dyspnea
- D. Urticaria
Correct Answer: B
Rationale: The symptoms of anaphylactic shock are dyspnea, feeling of fullness in the throat, cough, wheezing, extremely low blood pressure, tachycardia (heart rate >100 bpm), palpitations, syncope, cardiac arrest, urticaria, angioedema, pruritus, sweating, nausea, vomiting, and abdominal pain.