Nokea
Low doses of aspirin prolong bleeding time by selectively inhibiting synthesis of the following mediator in the platelets:
- A. Thromboxane Aâ‚‚
- B. 5-Hydroxytryptamine
- C. Platelet activating factor
- D. Prostacyclin
Correct Answer: A
Rationale: Low-dose aspirin irreversibly inhibits COX-1 in platelets, reducing thromboxane Aâ‚‚ production, which promotes platelet aggregation, thus prolonging bleeding time.
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While collecting a medication history, the patient admits to doubling the recommended dosage of an over-the-counter (OTC) medication, saying its harmless or they would require a prescription. What is the nurses best response?
- A. OTC drugs are serious medications and carry serious risks if not taken as directed.
- B. Taking medications like that is careless and you could kill yourself doing it.
- C. Sometimes you need to take more than the package directs to treat the symptoms.
- D. Did you notify your doctor of the increased dosage you were taking?
Correct Answer: A
Rationale: OTC drugs are no less a medication than prescription drugs and carry the same types of risks for overdosage and toxicity if directions are not followed. Although increasing the dosage is careless and dangerous, it is important to use the information as a teaching opportunity rather than scolding the patient. Agreeing with the patient or asking her if she talked to the doctor misses the teaching opportunity, which could be harmful for the patient.
Beta blocker which has less first pass metabolism and more excretion through kidney is
- A. Propranolol
- B. Sotalol
- C. Bisprolol
- D. Nadolol
Correct Answer: B
Rationale: Sotalol has minimal first-pass metabolism and is excreted renally.
Which of the following statements CORRECTLY describes the mechanism of action of imatinib mesylate in chronic myeloid leukemia:
- A. Inhibitor of tyrosine kinase
- B. Inhibitor of topoisomerase 1
- C. Inhibitor of topoisomerase 2
- D. It is an alkylating agent
Correct Answer: A
Rationale: Imatinib inhibits BCR-ABL tyrosine kinase in CML.
Adherence is improved when a drug can be given once daily. Which of the following drugs can be given once daily?
- A. Tacrine
- B. Donepezil
- C. Memantine
- D. Pyridostigmine
Correct Answer: B
Rationale: Donepezil's long half-life allows once-daily dosing, improving adherence.
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.