Nokea
Laboratory monitoring for patients on angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers should include:
- A. White blood cell counts with the drug dosage increased for elevations above 10,000 feet
- B. Liver function tests with the drug dosage stopped for alanine aminotransferase values twice that of normal
- C. Serum creatinine levels with the drug dosage reduced for values greater than 2.5 mg/dL
- D. Serum glucose levels with the drug dosage increased for levels greater than 120 mg/dL
Correct Answer: C
Rationale: Elevated creatinine (>2.5 mg/dL) indicates renal impairment, requiring dose adjustment.
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Patients whose total dose of prednisone will exceed 1 gram will most likely need a second prescription for:
- A. Metformin, a biguanide to prevent diabetes
- B. Omeprazole, a proton pump inhibitor to prevent peptic ulcer disease
- C. Naproxen, an NSAID to treat joint pain
- D. Furosemide, a diuretic to treat fluid retention
Correct Answer: B
Rationale: High-dose prednisone risks ulcers, warranting omeprazole; diabetes or fluid are less immediate.
The American Heart Association and the American Dietetic Association recommend a minimum daily fiber intake of for cardiovascular health:
- A. 10 mg/day
- B. 15 mg/day
- C. 20 mg/day
- D. 25 mg/day
Correct Answer: D
Rationale: 25 g/day of fiber is recommended to reduce cardiovascular risk by lowering cholesterol and improving glucose control.
There is a narrow margin between first appearance of adverse reaction to AChE inhibitors and serious toxic effects. Adverse reactions that require immediate action include:
- A. Dizziness and headache
- B. Nausea
- C. Decreased salivation
- D. Fasciculations of voluntary muscles
Correct Answer: D
Rationale: Fasciculations indicate potential cholinergic crisis, requiring urgent intervention.
What is the role of calcium supplements when patients take bisphosphonates?
- A. They must be restricted to allow the medication to work
- B. They must be taken in sufficient amounts to provide foundational elements for bone growth
- C. They must be taken at the same time as the bisphosphonates
- D. They only work with bisphosphonates if daily intake is restricted
Correct Answer: B
Rationale: Calcium supports bone health with bisphosphonates but must be timed separately (not C) to avoid interference.
Ipratropium bromide is
- A. Bronchoselective anticholinergic
- B. Used as mydriatic
- C. A selective MI anticholinergic useful in peptic ulcer
- D. An antiparkinsonism drug
Correct Answer: A
Rationale: Ipratropium is a bronchoselective anticholinergic used in COPD/asthma.