Nokea
Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required prior to prescribing warfarin.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: VCORC1 testing is recommended but not required before prescribing warfarin; it's optional to guide dosing.
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Which of the following shows high first pass metabolism:
- A. Propranolol
- B. Phenobarbitone
- C. Phenylbutazone
- D. Phenytoin
Correct Answer: A
Rationale: Propranolol undergoes extensive first-pass metabolism in the liver.
The nurse uses what term to describe the drug level required to have a therapeutic effect?
- A. Critical concentration
- B. Dynamic equilibrium
- C. Selective toxicity
- D. Active transport
Correct Answer: A
Rationale: A critical concentration of a drug must be present before a reaction occurs within the cells to bring about the desired therapeutic effect. A dynamic equilibrium is obtained from absorption of a drug from the site of drug entry, distribution to the active site, metabolism in the liver, and excretion from the body to have a critical concentration. Selective toxicity is the ability of a drug to attach only to those systems found in foreign cells. Active transport is the process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney.
A nurse is providing information to a client who has early Parkinson's disease and a new prescription for pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?
- A. Hallucinations
- B. Increased salivation
- C. Diarrhea
- D. Discoloration of urine
Correct Answer: A
Rationale: Pramipexole, a dopamine agonist, can cause hallucinations , especially in Parkinson's patients.
Data in the electronic health record that the provider reviews prior to a patient encounter varies with the clinic setting. In an urgent care clinic, the provider should review:
- A. The patient's current diagnosis and history
- B. Drugs the patient is currently taking
- C. Any recent previous encounter for the same problem as this visit and what was done
- D. All of the above
Correct Answer: D
Rationale: In urgent care, reviewing diagnosis, medications, and prior encounters ensures comprehensive care.
The drug, which interferes with metabolism of theophylline
- A. Gentamicin
- B. Penicillin
- C. Erythromycin
- D. Sulfonamide
Correct Answer: C
Rationale: Erythromycin inhibits cytochrome P-450, reducing theophylline metabolism.