Nokea
Immune globulin serums:
- A. Provide active immunity against infectious diseases
- B. Are contraindicated during pregnancy
- C. Are heated to above body temperature to kill most hepatitis, HIV, and other viruses such as parvovirus
- D. Are derived from pooled plasma of adults and contain specific antibodies in proportion to the donor population
Correct Answer: D
Rationale: Immune globulins are passive immunity from pooled plasma; they're not active , not contraindicated in pregnancy , and not heated .
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Azathioprine is useful in the following diseases EXCEPT:
- A. Rheumatoid arthritis
- B. Psoriatic arthritis
- C. Reactive arthritis
- D. osteoarthritis
Correct Answer: D
Rationale: Azathioprine is not typically used for osteoarthritis, a degenerative condition.
A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. After reaching the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.
The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day. If this is done:
- A. The initial dose of glargine is reduced by 20% to avoid hypoglycemia
- B. The initial dose of glargine is 2 to 10 units per day
- C. Patients who have been on high doses of NPH will need tests for insulin antibodies
- D. Obese patients may require more than 100 units per day
Correct Answer: A
Rationale: Switching to glargine reduces the dose by 20% to prevent hypoglycemia due to its steady action vs. NPH peaks.
A young adult female who is taking metronidazole (Flagyl) to treat trichomoniasis calls the nurse to report severe headache, flushing, palpitations, cramping, and nausea. What will the nurse do next?
- A. Ask about alcohol consumption
- B. Reassure her that these are harmless side effects
- C. Tell her that this signals a worsening of her infection
- D. Tell her to go to the emergency department immediately
Correct Answer: A
Rationale: Metronidazole with alcohol causes a disulfiram-like reaction (symptoms listed); it's not infection worsening or harmless . Patients who are taking metronidazole can experience a disulfiram-like reaction when they drink alcohol.
A nurse is caring for a child on the pediatric unit. A drug is ordered for the child, but there is no pediatric dose listed for the drug. To make sure that the right dose has been ordered, what will the nurse use to calculate the correct dose?
- A. Surface area
- B. Height
- C. Birth date
- D. Age at gestation
Correct Answer: A
Rationale: Surface area, calculated via nomograms using height and weight, is the most accurate method for pediatric dosing adjustments.