Effects of glucagon are:
- A. Positive inotropic and chronotropic effects
- B. Negative inotropic and chronotropic effects
- C. Inhibition of Gs protein and decrease of CAMP
- D. Activation of Gq and accumulation of Inositol triphosphate
Correct Answer: A
Rationale: Glucagon has positive inotropic and chronotropic effects on the heart, increasing contractility and rate.
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Administration of sulfonamide may intensify the action of tolbutamide, through:
- A. Activation of the islets of pancreas
- B. Direct action on the utilization of glucose
- C. Synergistic action
- D. Competing with tolbutamide in plasma protein binding
Correct Answer: D
Rationale: Sulfonamides displace tolbutamide from plasma proteins, increasing free drug levels and enhancing its hypoglycemic effect.
Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?
- A. Betamethasone, an inhaled corticosteroid
- B. Salmeterol, an inhaled long-acting beta-agonist
- C. Albuterol, a short-acting beta-agonist
- D. Montelukast, a leukotriene modifier
Correct Answer: B
Rationale: Salmeterol carries a Black Box Warning for increased asthma-related deaths, especially in African Americans, requiring caution; others are safer.
Which of the following is not an indication that growth hormone supplements should be discontinued?
- A. Imaging indication of epiphyseal closure
- B. Growth curve increases have plateaued
- C. Complaints of mild bone pain
- D. Achievement of anticipated height goals
Correct Answer: C
Rationale: Mild bone pain is a common side effect of growth hormone, not a stop signal; closure or plateau are.
A patient is considering using herbal supplements and asks the nurse about them. Which response by the nurse would be most appropriate?
- A. Herbal supplements are safe to use because they are regulated closely.'
- B. Herbal supplements can affect the way other medications will act.'
- C. Taking more than the recommended amount usually is not harmful because they are natural.'
- D. The risk of the supplement interacting with any prescription medications is extremely low.'
Correct Answer: B
Rationale: The nurse needs to explain to the patient that just because an herbal supplement is labeled 'natural' does not mean the supplement is safe or without harmful effects. Herbal supplements can act the same way as drugs and can cause medical problems if not used correctly or if taken in large amounts. Herbal supplements are not regulated by the FDA, so products lack standardization in relation to purity and potency. In addition, the patient should be warned not to take more than the recommended dose of any herbal health product or supplement. The problems that these products can cause are much more likely to occur if the patient takes too much or takes them for too long.
Phil is starting treatment with febuxostat (Uloric). Education of patients starting febuxostat includes:
- A. Gout may worsen with therapy
- B. Febuxostat may cause severe diarrhea
- C. He should consume a high-calcium diet
- D. He will need frequent CBC monitoring
Correct Answer: A
Rationale: Febuxostat can initially worsen gout as uric acid mobilizes; diarrhea or calcium aren't emphasized.