Nokea
Hepatitis B vaccine is contraindicated in patients who:
- A. Were born after less than 32 weeks gestation (give first dose at age 6 months)
- B. Are pregnant
- C. Are on hemodialysis
- D. Are allergic to yeast
Correct Answer: D
Rationale: Hepatitis B vaccine is contraindicated in yeast allergy (it's yeast-derived); prematurity , pregnancy , or dialysis are not.
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A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is thinking about taking St. John's wort but wants to know if it is safe first. The nurse begins by questioning what other medications the patient takes and would be concerned about a drug-alternative drug interaction if the patient is also taking what type of medication?
- A. Antihistamines
- B. Analgesics
- C. Antibiotics
- D. Oral contraceptives
Correct Answer: D
Rationale: St. John's wort can interact with oral contraceptives that alter drug metabolism, which can decrease the effectiveness of the contraceptive. Analgesics, antibiotics, and antihistamines can be taken in combination with St. John's wort without known adverse effects.
Patients who are on long-term aspirin therapy should have ____ annually.
- A. Complete blood count
- B. Salicylate level
- C. Amylase
- D. Urine analysis
Correct Answer: A
Rationale: Annual CBC monitors for aspirin-related bleeding; salicylate isn't routine yearly.
Angina pectoris, tachycardia, and arrhythmias are possible adverse effects of which of the following drugs?
- A. Clonidine
- B. Phenylephrine
- C. Propranolol
- D. Salbutamol
Correct Answer: D
Rationale: Salbutamol, a beta-2 agonist, can cause cardiac stimulation as a side effect.
The mean weight of 500 college students is 70 kg and the standard deviation is 3 kg. Assuming that the weight is normally distributed, determine how many students weigh exactly 64 kg.
- B. 5
- C. 10
- D. 15
Correct Answer: A
Rationale: In a continuous normal distribution, the probability of an exact value (e.g., P(X=64)) is 0, as probability is measured over intervals, not points. Thus, 0 students, as per the document.
A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
- A. The impact of the placebo effect on the patient's response.
- B. The accumulative effect of the drug if it has been taken for many years.
- C. The impact of the warmer environment on the patient's physical status.
- D. Problems with patient compliance with the drug regimen while on vacation.
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and moves to a warmer climate, there is a chance that the patient's blood pressure will drop too low, resulting in dizziness and feelings of weakness. Even mild dehydration could exacerbate these effects. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.