Glucocorticoids:
- A. Decrease amount of immunocompetent cells and macrophages in the blood
- B. Stimulate activity of macrophages and monocytes
- C. Increase amount of T lymphocytes
- D. Stimulate production of antibodies
Correct Answer: A
Rationale: Glucocorticoids reduce immunocompetent cells and macrophages, contributing to their immunosuppressive effects.
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All are pro drugs except
- A. Sulindac
- B. Codeine
- C. Talampicillin
- D. Chlorpromazine
Correct Answer: D
Rationale: Chlorpromazine is active as is; others are prodrugs.
The nurse is preparing to administer a prescribed drug to a patient. The patient looks at the tablet and says, 'This doesn't look like my usual pill.' Which response by the nurse would be most appropriate?
- A. This is the same pill your doctor has been ordering.'
- B. It must be from a different manufacturer.'
- C. It looks different? Are you sure?'
- D. Let me double check with your doctor and the order.'
Correct Answer: D
Rationale: If the patient makes any statement about the drug, the nurse needs to hold the drug and investigate the patient's statement, double checking the chart and the order and obtaining clarification and/or confirmation from the prescriber. It may be that the dosage or manufacturer has changed and that is what makes the pill look different. It is always important to err on the side of caution. Telling the patient that the pill is the same or that it is from a different manufacturer may be true, but the nurse needs to confirm that before giving it to the patient. Repeating the patient's statement and then asking him if he is sure is inappropriate because it implies that the patient is incorrect.
Nicotine has a variety of effects on nicotinic receptors throughout the body. Which of the following is NOT an effect of nicotine?
- A. Vasodilation and decreased heart rate
- B. Increased secretion of gastric acid and motility of the GI smooth muscle
- C. Release of dopamine at the pleasure center
- D. Stimulation of the locus coeruleus
Correct Answer: A
Rationale: Nicotine causes vasoconstriction and increased heart rate, not vasodilation.
Where are tight junctions created by two adjoining cells located?
- A. Bone
- B. Brain
- C. Skin
- D. Liver
Correct Answer: B
Rationale: Tight junctions are prominent in the brain (blood-brain barrier), restricting drug entry, unlike the liver (fenestrated) or bone/skin (different barriers).
The nurse is reviewing the patient's admission medication orders. What order would the nurse to question?
- A. Digoxin .5 mg orally now give one dose only
- B. Lasix 20 mg. IV every 4 hours times 3
- C. Gentamicin 80 mg IV to infuse over 1 hour every 12 hours
- D. Acetaminophen 650 mg PO every 4 hours as needed for pain
Correct Answer: A
Rationale: Digoxin .5 mg (0.5 mg) is a high initial dose; typical is 0.125-0.25 mg, requiring clarification.
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