Nokea
James is a 52-year-old overweight smoker taking theophylline for his persistent asthma. He tells his provider he is going to start the Atkin's diet for weight loss. The appropriate response would be:
- A. Congratulate him on making a positive change in his life
- B. Recommend he discuss this with his provider since the Atkin's diet increases the risk of theophylline toxicity
- C. Tell him the Atkin's diet has no effect on theophylline
- D. Suggest adding a steroid inhaler to manage asthma during the diet
Correct Answer: B
Rationale: The Atkin's diet (high-fat, low-carb) can increase theophylline levels, risking toxicity ; simple congratulations or dismissal overlook this interaction.
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The type of adverse drug reaction that is idiosyncratic when a drug given in the usual therapeutic doses is type:
- A. A
- B. B
- C. C
- D. D
Correct Answer: B
Rationale: Type B reactions are idiosyncratic, unpredictable responses to normal doses, unlike dose-related Type A or chronic Type C/D.
After teaching a group of nursing students about pharmacokinetics, the instructor determines that the teaching was successful when the students identify which of the following as the site for the metabolism of most drugs?
- A. Liver
- B. Lungs
- C. Kidneys
- D. Intestinal mucosa
Correct Answer: A
Rationale: Although the kidneys, lungs, plasma, and intestinal mucosa may aid in the metabolism of drugs, most drugs are metabolized by the liver.
While collecting a medication history, the patient admits to doubling the recommended dosage of an over-the-counter (OTC) medication, saying its harmless or they would require a prescription. What is the nurses best response?
- A. OTC drugs are serious medications and carry serious risks if not taken as directed.
- B. Taking medications like that is careless and you could kill yourself doing it.
- C. Sometimes you need to take more than the package directs to treat the symptoms.
- D. Did you notify your doctor of the increased dosage you were taking?
Correct Answer: A
Rationale: OTC drugs are no less a medication than prescription drugs and carry the same types of risks for overdosage and toxicity if directions are not followed. Although increasing the dosage is careless and dangerous, it is important to use the information as a teaching opportunity rather than scolding the patient. Agreeing with the patient or asking her if she talked to the doctor misses the teaching opportunity, which could be harmful for the patient.
The patient has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a (Rebif). The patient takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per injection. If the patient takes an injection on Monday, how much of the drug would still be in the patient's system when she takes her next injection on Wednesday, assuming the half-life of the drug is 24 hours?
- A. 22 mcg
- B. 16.5 mcg
- C. 11 mcg
- D. 5.5 mcg
Correct Answer: C
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to 1 half the peak level it previously achieved. On Tuesday, there would be 22 mcg remaining in the body, so option A is incorrect. On Wednesday 11 mcg would remain, so option C is the correct answer. At 12 hours before taking the next dose on Wednesday, there would be 16.5 mcg remaining. If the injection were not taken on Wednesday, 12 hours after the dose was due, there would be 5.5 mcg remaining.
Which of the following statements CORRECTLY describes the mechanism of action of imatinib mesylate in chronic myeloid leukemia:
- A. Inhibitor of tyrosine kinase
- B. Inhibitor of topoisomerase 1
- C. Inhibitor of topoisomerase 2
- D. It is an alkylating agent
Correct Answer: A
Rationale: Imatinib inhibits BCR-ABL tyrosine kinase in CML.