Nokea
Kenneth is taking warfarin and is asking about what he can take for minor aches and pains. The best recommendation is:
- A. Ibuprofen 400 mg three times a day
- B. Acetaminophen, not to exceed 4 grams per day
- C. Prescribe acetaminophen with codeine
- D. Aspirin 640 mg three times a day
Correct Answer: B
Rationale: Acetaminophen is safest with warfarin, avoiding bleeding risks from ibuprofen or aspirin ; codeine is unnecessary for minor pain.
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Which of the following is the most frequent cause of diarrhea and flatulance:
- A. Acarbose
- B. Glibenclamide
- C. Metformin
Correct Answer: A
Rationale: Acarbose inhibits carbohydrate digestion in the gut, leading to increased fermentation by gut bacteria, causing diarrhea and flatulence.
Release of the mineralcorticoids is stimulated with:
- A. Low concentration of \mathrm{Na}+ in the blood
- B. Hypokalemia
- C. Low concentration of angiotensin II in the blood
- D. Low concentration of \mathrm{Mg} 2+ in the blood
Correct Answer: A
Rationale: Low blood sodium stimulates aldosterone release via the renin-angiotensin system.
Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?
- A. A 35-year-old woman with cervical cancer
- B. A 41-year-old man with kidney stones
- C. A 50-year-old man with cirrhosis of the liver
- D. A 62-year-old woman in acute renal failure
Correct Answer: C
Rationale: The liver is the most important site of drug metabolism. If the liver is not functioning effectively, as in patients with cirrhosis, drugs will not metabolize normally so that toxic levels could develop unless dosage is reduced. A patient with cervical cancer or kidney stones would not be expected to have altered ability to metabolize drugs so long as no liver damage existed. The patient with renal failure would have altered excretion of the drugs through the renal system but metabolism would not be impacted.
Which of the following drugs has been shown to restore corticosteroid responsiveness for Bronchial Asthma:
- A. Salbutamol
- B. Sodium cromoglycate
- C. Zifirlukast
- D. Montelukast
Correct Answer: D
Rationale: Montelukast, a leukotriene inhibitor, enhances corticosteroid efficacy in asthma.
Which of the following beta-blockers also has additional alpha-blocking activity?
- A. Nadolol
- B. Pindolol
- C. Labetalol
- D. Esmolol
Correct Answer: C
Rationale: Labetalol has both beta and alpha-1 blocking activity, making it unique among beta-blockers.