Nokea
Indicate the drug belonging to fibrinoliytic inhibitors:
- A. Aminocapronic acid
- B. Ticlopidine
- C. Streptokinase
- D. Vitamin K
Correct Answer: A
Rationale: Step-by-step rationale for why Aminocaproic acid (A) is the correct answer:
1. Aminocaproic acid is a fibrinolytic inhibitor that prevents the breakdown of blood clots.
2. It works by inhibiting the activation of plasminogen to plasmin, which is essential for clot dissolution.
3. Therefore, Aminocaproic acid belongs to the class of fibrinolytic inhibitors.
Summary of why the other choices are incorrect:
- Ticlopidine (B) is a platelet aggregation inhibitor, not a fibrinolytic inhibitor.
- Streptokinase (C) is a fibrinolytic drug that promotes clot breakdown, not an inhibitor.
- Vitamin K (D) is essential for clotting factors synthesis, not a fibrinolytic inhibitor.
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Which of the following adverse effects is associated with lithium treatment?
- A. Cardiovascular anomalies in the newborn
- B. Thyroid enlargement
- C. Nephrogenic diabetes insipidus
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D. Lithium treatment is associated with various adverse effects. Cardiovascular anomalies in the newborn can occur if lithium is taken during pregnancy. Thyroid enlargement is a common side effect of lithium, as it interferes with thyroid hormone synthesis. Nephrogenic diabetes insipidus is another well-known adverse effect of lithium, leading to excessive urination and thirst. Choosing option D is correct as it encompasses all the mentioned adverse effects associated with lithium treatment. Other choices are incorrect as they do not cover the full spectrum of adverse effects linked to lithium.
Because of proven beneficial effects on 'cardiac remodeling', these agents are now indicated as first line therapy in CHF patients. Which of the following is representative of this group of drugs?
- A. Hydrochlorothiazide
- B. Enalapril
- C. Furosemide
- D. Carvedilol
Correct Answer: B
Rationale: Enalapril, an ACE inhibitor, reduces cardiac remodeling by decreasing afterload and preload, making it a first-line CHF therapy.
The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?
- A. Orange juice
- B. Fried eggs over-easy
- C. Salami and Swiss cheese sandwich
- D. Biscuits and honey
Correct Answer: C
Rationale: The correct answer is C: Salami and Swiss cheese sandwich. This is because salami and Swiss cheese are high in tyramine, which can cause a hypertensive crisis in patients taking MAOIs due to their inhibitory effect on monoamine oxidase. Orange juice (A) does not contain tyramine. Fried eggs over-easy (B) and biscuits with honey (D) are also safe choices as they do not contain high levels of tyramine. Therefore, the need for additional teaching is indicated by the selection of foods high in tyramine like salami and Swiss cheese.
All of the following statements regarding verapamil are true EXCEPT:
- A. It blocks L-type calcium channels
- B. It increases heart rate
- C. It relaxes coronary artery smooth muscle
- D. It depresses cardiac contractility
Correct Answer: B
Rationale: Verapamil is a calcium channel blocker that decreases heart rate by blocking L-type calcium channels in the heart. Choice B, stating it increases heart rate, is incorrect. Verapamil relaxes coronary artery smooth muscle (Choice C) and depresses cardiac contractility (Choice D), making them true statements. So, the correct answer is B as it contradicts the pharmacological effects of verapamil.
A patient with bipolar disorder, mania, relapsed after discontinuing lithium. The health care provider prescribes lithium 600 mg BID and olanzapine (Zyprexa) 10 mg BID. What is the rationale for addition of olanzapine to the lithium regime? It will:
- A. minimize the side effects of lithium.
- B. bring hyperactivity under rapid control.
- C. potentiate the antimanic action of lithium.
- D. be used for long-term control of hyperactivity.
Correct Answer: B
Rationale: The correct answer is B: bring hyperactivity under rapid control. Olanzapine, an atypical antipsychotic, is commonly used in the acute treatment of mania due to its ability to rapidly control symptoms like hyperactivity. Lithium, on the other hand, is used for long-term mood stabilization in bipolar disorder. The addition of olanzapine helps address the acute manic symptoms while lithium works on the long-term management. Choices A and C are incorrect as olanzapine does not minimize lithium's side effects or potentiate its antimanic action. Choice D is incorrect as olanzapine is typically used for acute symptom management, not for long-term control of hyperactivity.