Nokea
Glucocorticoids enhance:
- A. Inhibition of phospholipase A2 in leukocytes with stimulation of annexin synthesis
- B. Decrease of thrombocyte activating factor via inhibition of 5 lipooxigenase
- C. Inhibition of leukotriene synthesis and decrease of lyso-glycerilphosphorilcholine production
- D. inhibition of prostaglandin synthesis via blocking 12 lypooxigenase
Correct Answer: A
Rationale: Glucocorticoids inhibit phospholipase A2, reducing inflammatory mediators by stimulating annexin (lipocortin) synthesis.
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Which of the following two cyclooxygenase isoenzymes is constitutively expressed?
- A. COX-1
- B. COX-2
Correct Answer: A
Rationale: COX-1 is constitutively expressed in most tissues, maintaining normal functions, unlike inducible COX-2.
The nurse, working on the maternity unit, receives a call from a pregnant woman asking how she can know whether a medication is safe to take while pregnant. What is the nurses best response?
- A. You can take any drug indicated as a Category A.
- B. No medications should be taken during pregnancy.
- C. Never take medication until you receive approval from your health care provider.
- D. Most medications are safe but you need to weigh benefit against risk.
Correct Answer: C
Rationale: The best response to a pregnant woman asking about medication usage is to talk with her obstetric practitioner because the best advice will come from someone who knows their health and pregnancy history. While Category A drugs have no known risk, they may be contraindicated by the woman's health condition or pregnancy issues and many pregnant women would not know what it means to be a Category A drug. Medications can be helpful during pregnancy if taken safely and appropriately. Although risk benefit needs to be weighed, it should occur with advice from the obstetric practitioner.
Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling depressed and having 'strange' thoughts. The appropriate initial action would be:
- A. Increase her dose
- B. Assess for suicidal ideation
- C. Discontinue the medication immediately
- D. Decrease her dose to half then slowly titrate up the dose
Correct Answer: B
Rationale: Gabapentin can cause mood changes; assessing for suicidal ideation is the priority.
A nurse is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol?
- A. Asthma
- B. Glaucoma
- C. Hypertension
- D. Tachycardia
Correct Answer: A
Rationale: Propranolol is contraindicated in asthma due to risk of bronchoconstriction.
A patient has been using sleeping pills every night for the past several months. Now admitted to the hospital, he is prescribed his usual dose of sleeping pill. After administration, the patient continues to be restless and is wide awake. The nurse notifies the health care provider, who prescribes an increased dose. After receiving the new dose, the patient falls asleep. The nurse interprets this as which of the following?
- A. Drug idiosyncrasy
- B. Cumulative drug effect
- C. Drug tolerance
- D. Toxic reactions
Correct Answer: C
Rationale: The patient has developed drug tolerance and has to be administered an increased dosage of the drug to achieve the desired effect. Cumulative drug effect occurs when the body is unable to metabolize and excrete one (normal) dose of a drug before the next dose is given. Drug idiosyncrasy is a term used to describe any unusual or abnormal reaction to a drug. Toxic reactions are caused when blood concentration levels exceed the therapeutic levels of a drug.