Nokea
Elderly patients who are started on levothyroxine for hypothyroidism may experience which of the following as a side effect that would require reevaluation of dosage?
- A. Excessive sedation
- B. Tachycardia and angina
- C. Weight gain
- D. Cold intolerance
Correct Answer: B
Rationale: Levothyroxine can cause tachycardia and angina in the elderly if overdosed; sedation or weight gain suggest underdosing.
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Which of the following is a disadvantage of IM administration?
- A. Larger volumes can be used
- B. Can affect lab tests
- C. Painful
- D. B and C
Correct Answer: C
Rationale: Intramuscular (IM) administration is painful due to needle insertion, though larger volumes are an advantage; affecting lab tests is less specific, making C the primary disadvantage.
After teaching a group of nursing students about pharmacokinetics, the instructor determines that the teaching was successful when the students identify which of the following as the first phase?
- A. Metabolism
- B. Absorption
- C. Distribution
- D. Excretion
Correct Answer: B
Rationale: Pharmacokinetics refers to the transportation activity of drugs in the body after administration. The first component is absorption. This is followed by distribution, metabolism, and finally excretion.
A 52-year-old overweight woman presents to the clinic for a diabetes management. She had not been doing well controlling her blood sugars with metformin. Her last hemoglobin A1c was 13.4%, despite her taking her medication every day. The physician decides to start her on a long-acting insulin that is injected only once a day for better glucose control. Also, he wants the insulin to have a minimal risk of hypoglycemia. What is the most likely medication given to this patient?
- A. Insulin aspart
- B. Insulin glargine
- C. Insulin lispro
- D. NPH insulin
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin administered once daily, with a lower risk of hypoglycemia compared to other insulins.
Patients with pheochromocytoma should avoid which of the following classes of drugs because of the possibility of developing hypertensive crisis?
- A. Expectorants
- B. Beta-2-agonists
- C. Antitussives
- D. Antihistamines
Correct Answer: B
Rationale: Beta-2-agonists can stimulate catecholamine release in pheochromocytoma, risking hypertensive crisis; other classes are safer.
A patient is prescribed lidocaine for ventricular arrhythmias. Which side effect should the nurse monitor for?
- A. Hypotension
- B. Nausea
- C. Seizures
- D. Bradycardia
Correct Answer: C
Rationale: Lidocaine, a Class IB antiarrhythmic, can cause CNS side effects like seizures at high doses, a key monitoring point.