Immunosupressive effects of glucocorticoids are denominated with:
- A. Decrease of interleukins 1,2
- B. Activation of lymphocyte proliferation
- C. Increase amount of T lymphocytes
- D. Activation of lymphocyte transport at the site of antigen stimulation
Correct Answer: A
Rationale: Glucocorticoids suppress immunity by decreasing pro-inflammatory cytokines like interleukins 1 and 2.
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Which action will the nurse take if a dosage is unclear on a health care provider's order?
- A. Ask the patient what dosage was given in the past.
- B. Ask another physician to determine the correct dosage.
- C. Tell the patient that the medication will not be given.
- D. Contact the health care provider to verify the correct dosage.
Correct Answer: D
Rationale: Any questionable orders should be verified by the health care provider who wrote the orders. The patient is not a reliable source of verification. The physician who wrote the order should verify it. It would be a medication error to withhold the dose instead of verifying it.
A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider?
- A. Serum Sodium 144 mEq/L
- B. Urine output 120 mL in 4 hr
- C. Serum Potassium 5.2 mEq/L
- D. Blood Pressure 140/90 mm Hg
Correct Answer: C
Rationale: Hyperkalemia (5.2 mEq/L, C) is a serious side effect of spironolactone, a potassium-sparing diuretic.
The term 'chemical antagonism' means that:
- A. two drugs combine with one another to form an inactive compound
- B. two drugs combine with one another to form a more active compound
- C. two drugs combine with one another to form a more water soluble compound
- D. two drugs combine with one another to form a more fat soluble compound
Correct Answer: A
Rationale: Chemical antagonism involves a direct chemical interaction rendering the drug inactive, e.g., chelation.
A nurse working in radiology administers iodine to a patient who is having a computerized axial tomography (CAT) scan. A nurse working on an oncology unit administers chemotherapy to patients who have cancer. At the Public Health Department, a nurse administers a measles-mumps-rubella (MMR) vaccine to a 14month-old child as a routine immunization. Which branch of pharmacology best describes the actions of all three nurses?
- A. Pharmacoeconomics
- B. Pharmacotherapeutics
- C. Pharmacodynamics
- D. Pharmacokinetics
Correct Answer: B
Rationale: Pharmacology is the study of the biologic effects of chemicals. Nurses are involved with clinical pharmacology or pharmacotherapeutics, which is a branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. The nurse working in radiology is administering a drug to help diagnose a disease. The nurse working on an oncology unit is administering a drug to help treat a disease. Pharmacoeconomics includes any costs involved in drug therapy. Pharmacodynamics involves how a drug affects the body, and pharmacokinetics is how the body acts on the drug.
Your lab group has been evaluating the effects of 'Ultron' a new drug for the treatment of intractable hiccups. When administered over a wide concentration range, three dose response relationships were defined in test subjects. Using facial flushing as an unwanted side effect, what would be the estimated therapeutic index for Ultron?
- A. 0.1
- B. 100
- C. 10
- D. Can't determine
Correct Answer: C
Rationale: The therapeutic index (TI) is typically a ratio of the dose causing a toxic effect to the dose producing a therapeutic effect. Without specific data, 10 is a reasonable estimate for a drug with defined dose-response relationships, as per the answer key.