Nokea
Drugs that use CYP 3A4 isoenzymes for metabolism may:
- A. Induce the metabolism of another drug
- B. Inhibit the metabolism of another drug
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: C
Rationale: Choice C is correct because CYP 3A4 drugs can induce (speed up) or inhibit (slow down) metabolism of other drugs sharing this pathway, affecting their levels and efficacy. Choice A is incorrect as it's only half the story—induction happens, but inhibition does too. Choice B is wrong because it misses induction potential. Choice D is incorrect since both effects are well-documented with CYP 3A4.
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What should be the nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk?
- A. Administer nitroglycerin
- B. Have the client sit down
- C. Obtain an electrocardiogram
- D. Apply oxygen
Correct Answer: B
Rationale: The nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk is to have the client sit down. Sitting down reduces the workload on the heart and may alleviate pain by improving oxygen supply. This action aims to reduce the strain on the heart and improve oxygen delivery to the myocardium, which can help relieve the symptoms of angina pectoris. Administering nitroglycerin could be the next step after having the client sit down if the pain persists. Obtaining an electrocardiogram and applying oxygen are not the immediate priority actions when dealing with angina pectoris symptoms.
When a medication is added to a regimen for a synergistic effect, the combined effect of the drugs is:
- A. The sum of the effects of each drug individually
- B. Greater than the sum of the effects of each drug individually
- C. Less than the effect of each drug individually
- D. Not predictable, as it varies with each individual
Correct Answer: B
Rationale: Choice B is correct because synergy means the combined effect exceeds the sum of individual effects, enhancing therapeutic outcomes beyond additive results. Choice A is incorrect as it describes an additive, not synergistic, effect. Choice C is wrong because synergy doesn't reduce efficacy below individual effects. Choice D is incorrect since synergy is a predictable pharmacological principle, not entirely variable.
Risks to the fetus in the second trimester include:
- A. Exposure to teratogens causing abnormal organ development
- B. Maternal use of tobacco causing intrauterine growth restriction
- C. Maternal hypertension causing placental insufficiency
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because the second trimester involves growth, and tobacco restricts it via vasoconstriction, a key risk then. Choice A is incorrect as teratogens primarily affect organ development in the first trimester. Choice C is wrong because hypertension's placental effects are more third-trimester prominent. Choice D is incorrect since B is the specific second-trimester concern.
Signs of tolerance include:
- A. Needing higher doses for the same effect
- B. Reduced side effects over time
- C. Increased sensitivity to the drug
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because tolerance is defined by needing more drug for the same effect due to body adaptation, per pharmacokinetic principles. Choice B is incorrect as reduced side effects may occur but aren't the definition. Choice C is wrong because sensitivity decreases, not increases. Choice D is incorrect since only A fits.
The healthcare provider is evaluating the effects of care for a client with deep vein thrombosis (DVT). Which limb observations should the provider note as indicating the least success in meeting the outcome criteria for this problem?
- A. Pedal edema that is 3+
- B. Slight residual calf tenderness
- C. Skin warm, equal temperature in both legs
- D. Calf girth 1/8 inch larger than the unaffected limb
Correct Answer: A
Rationale: Significant pedal edema, indicated by 3+, suggests ongoing or worsening venous insufficiency. This can be a sign that the care provided has not been effective in managing the deep vein thrombosis (DVT) and the associated complications. Monitoring and addressing pedal edema is crucial in the evaluation of DVT treatment outcomes and overall patient care. Choices B, C, and D are not indicative of the least success in meeting the outcome criteria for DVT. Slight residual calf tenderness, skin warmth, and a slightly larger calf girth do not necessarily point towards treatment failure or lack of improvement in DVT management.