Larry has heart failure, which is being treated with digoxin because it exhibits:
- A. Negative inotropism
- B. Positive chronotropism
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: D
Rationale: Digoxin has positive inotropic effects, increasing contractility, not negative or chronotropic.
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Cecilia presents with depression associated with complaints of fatigue, sleeping all the time, and lack of motivation. An appropriate initial antidepressant for her would be:
- A. Fluoxetine (Prozac)
- B. Paroxetine (Paxil)
- C. Amitriptyline (Elavil)
- D. Duloxetine (Cymbalta)
Correct Answer: D
Rationale: Duloxetine addresses both depression and fatigue, unlike sedating options.
Which of the following is used for treatment of hyperthyroidism:
- A. Liothironine
- B. Levothiroxine
- C. Propilthiouracil
- D. Liotrix
Correct Answer: C
Rationale: Propylthiouracil inhibits thyroid hormone synthesis, making it a standard treatment for hyperthyroidism.
All nonsteroidal anti-inflammatory drugs (NSAIDS) have an FDA Black Box Warning regarding:
- A. Potential for causing life-threatening GI bleeds
- B. Increased risk of developing systemic arthritis with prolonged use
- C. Risk of life-threatening rashes, including Stevens-Johnson
- D. Potential for transient changes in serum glucose
Correct Answer: A
Rationale: NSAIDs carry a Black Box Warning for GI bleeding risk; rashes or glucose aren't highlighted.
The nurse learns that a drug needed by the patient is classified as an orphan drug and recognizes what as a reason for this classification? (Select one that does not apply.)
- A. The drug is rarely prescribed.
- B. The drug has dangerous adverse effects.
- C. The drug treats a rare disease.
- D. The patent on the medication is still effective.
Correct Answer: D
Rationale: Drugs are classified as orphan drugs when they are not financially viable for a drug company to produce either because of risk for lawsuits about adverse effects or because the drug is not prescribed, which is often seen in rare diagnoses. Generic drugs are not produced until the patent expires, but this has no impact on classifying a particular drug as an orphan drug. Generic drugs are often produced by companies that only manufacture drugs without conducting research, but this has no bearing on the classification of orphan drugs.
A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
- A. Calcium chloride
- B. Calcium gluconate
- C. Calcitonin (Miacalcin)
- D. Large doses of vitamin D
Correct Answer: C
Rationale: The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the serum calcium concentration.
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