Nokea
If you inject a drug with a pH of 6.5 and pka of 8.1 into a tissue with a pH of 7.4, to what extent would you expect this drug to be ionized in the tissue?
- A. over 50%
- B. 50%
- C. under 50%
- D. 100%
Correct Answer: A
Rationale: The percentage of ionization of a weak acid or base can be estimated using the Henderson-Hasselbalch equation:
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An adolescent client will receive Depo-Provera as a method of birth control. She asks the nurse how long the drug will be effective. What is the best response by the nurse?
- A. 2 months
- B. 6 months
- C. 1 year
- D. 3 months
Correct Answer: D
Rationale: Depo-Provera, a progestin injection, provides contraception by inhibiting ovulation for 3 months , requiring re-administration every 12 weeks. This duration is based on its pharmacokinetic profile, ensuring reliable hormone levels. Two months underestimates, risking unprotected gaps. Six months or 1 year overestimate, reducing efficacy mid-cycle. The nurse's accurate response (D) educates the client on timing, ensuring adherence and preventing unintended pregnancy, aligning with clinical standards for injectable contraceptives.
ACE inhibitors…
- A. Block the vasoconstrictor and aldosterone from producing effects of angiotensin II at the receptor site
- B. Blocks stimulation of beta 1 and beta 2 at the receptor sites
- C. Blocks the conversion of angiotensin I to the vasoconstrictor angiotensin II
- D. None of the above
Correct Answer: A
Rationale: ACE inhibitors, such as enalapril and lisinopril, work by blocking the enzyme angiotensin-converting enzyme (ACE), which is responsible for converting angiotensin I into angiotensin II. By inhibiting this conversion, ACE inhibitors prevent the vasoconstrictor and aldosterone-stimulating effects of angiotensin II at the receptor sites. This leads to vasodilation, decreased blood pressure, and reduced aldosterone secretion. This mechanism of action makes ACE inhibitors an important class of medications for managing conditions such as hypertension, heart failure, and chronic kidney disease.
The following are anticoagulants that do not require monitoring of INR:
- A. Rivaroxaban
- B. Apixaban
- C. Dabigatran
- D. All of the above
Correct Answer: D
Rationale: These are direct oral anticoagulants (DOACs), which do not require regular INR monitoring.
The pregnant patient tells the nurse that her prescribed medication is not as effective as it was before her pregnancy. What is the best response by the nurse?
- A. This is because your blood volume has increased
- B. Tell me how you have been taking your medication
- C. This is because your baby is receiving part of the medication
- D. Maybe the medication has expired; check the label
Correct Answer: A
Rationale: Pregnancy increases blood volume (50% more), diluting drugs, reducing efficacy-e.g., lower concentration per unit volume, a pharmacokinetic shift. Asking about administration checks adherence, not cause. Baby receiving drug is unlikely-placental transfer varies. Expiration is a guess, not tied to pregnancy. Blood volume explains the change, addressing her concern.
What is a side effect of Heparin?
- A. nausea
- B. diarrhea
- C. bleeding
- D. bronchospasms
Correct Answer: C
Rationale: A common side effect of Heparin, which is an anticoagulant medication, is the risk of bleeding. Heparin works by preventing the formation of blood clots, which can lead to a bleeding risk as it inhibits the normal clotting process. Patients taking Heparin should be monitored closely for signs of bleeding, such as easy bruising, prolonged bleeding from minor cuts, or blood in the urine or stools. It is important for healthcare providers to closely monitor patients on Heparin therapy and adjust the dosage as needed to minimize the risk of excessive bleeding.