Nokea
Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide:
- A. Can be given to patients of all ages, including infants and children, for viral gastroenteritis
- B. Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
- C. Is the treatment of choice for the diarrhea associated with E. coli 0157
- D. May be used in pregnancy and by lactating women
Correct Answer: B
Rationale: Loperamide slows motility to reduce diarrhea; it's not for infants , E. coli 0157 (C, risks toxicity), or universally safe in pregnancy .
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Patients taking warfarin need to be educated about the vitamin K content of foods to avoid therapeutic failure. Foods high in vitamin K that should be limited to no more than one serving per day include:
- A. Spinach
- B. Milk
- C. Romaine lettuce
- D. Cauliflower
Correct Answer: A
Rationale: Spinach is high in vitamin K, which can antagonize warfarin's anticoagulant effect if consumed excessively.
A 52-year-old overweight woman presents to the clinic for a diabetes management. She had not been doing well controlling her blood sugars with metformin. Her last hemoglobin A1c was 13.4%, despite her taking her medication every day. The physician decides to start her on a long-acting insulin that is injected only once a day for better glucose control. Also, he wants the insulin to have a minimal risk of hypoglycemia. What is the most likely medication given to this patient?
- A. Insulin aspart
- B. Insulin glargine
- C. Insulin lispro
- D. NPH insulin
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin administered once daily, with a lower risk of hypoglycemia compared to other insulins.
The choice of diuretic to use in treating hypertension is based on:
- A. Presence of diabetes with loop diuretics being used for these patients
- B. Level of kidney function with a thiazide diuretic being used for an estimated glomerular filtration rate higher than the mid-40 mL/min range
- C. Ethnicity with aldosterone antagonists best for African Americans and older adults
- D. Presence of hyperlipidemia with higher doses needed for patients with LDL above 130 mg/dL
Correct Answer: B
Rationale: Thiazides are effective with GFR >40-50 mL/min; loops are used for lower GFR.
Herbs and supplements are regulated by the U.S. Food and Drug Administration.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: Herbs and supplements are not regulated as drugs by the FDA; they fall under dietary supplement rules.
A nurse is providing teaching for a client who has a new prescription for Metformin. Which of the following adverse effects of Metformin should be correct the client to report to the provider?
- A. Somnolence
- B. Constipation
- C. Fluid retention
- D. Weight gain
Correct Answer: A
Rationale: Somnolence could indicate lactic acidosis, a rare but serious metformin side effect to report.