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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After teaching a group of students about the different routes of medication administration, the nursing instructor determines that the teaching was successful when the students identify which of the following as a topical drug?
- A. Capsule
- B. Suppository
- C. Nebulized bronchodilator
- D. Nicotine patch
Correct Answer: B
Rationale: Topical drugs are drugs that are applied to the outer layer of the skin but not absorbed through the skin, such as eyedrops and suppositories. A nebulized bronchodilator is an inhaled medication. A nicotine patch delivers the medication transdermally; that is, it is readily absorbed from the skin. A capsule is a form of oral medication.
Patients need to be instructed regarding the drug interactions with St John's wort, including:
- A. MAO inhibitors
- B. Serotonin reuptake inhibitors
- C. Over-the-counter cough and cold medications
- D. All of the above
Correct Answer: D
Rationale: St John's wort interacts with MAOIs, SSRIs (risk of serotonin syndrome), and OTC drugs via CYP450 induction.
Where are large fenestrations or slit junctions located?
- A. Bone
- B. Brain
- C. Skin
- D. Liver
Correct Answer: D
Rationale: The liver has large fenestrations in sinusoidal endothelium, allowing easy drug passage, unlike the brain (tight junctions) or bone/skin (less permeable).
Which of the following is seen in first order kinetics
- A. Rate depends upon plasma cone.
- B. Rate does not depend on plasma cone.
- C. Rate depends upon plasma protein binding
- D. Elimination depends upon amount of drug
Correct Answer: A
Rationale: In first-order kinetics, the elimination rate is proportional to plasma concentration.
A 35-year-old male patient is admitted to the hospital with pneumonia. He was originally being treated at home, but became worse when he quit taking his antibiotic prematurely. What is an appropriate nursing diagnosis for this patient?
- A. Deficient knowledge: monitoring temperature
- B. Noncompliance
- C. Risk for injury related to hypoxia
- D. Non-adherence: overuse
Correct Answer: B
Rationale: Stopping antibiotics early indicates noncompliance, worsening his condition.