Nokea
Many patients with hyperlipidemia are treated with more than one drug. Combining a fibric acid derivative such as gemfibrozil with which of the following is not recommended? The drug and the reason must both be correct for the answer to be correct.
- A. Reductase inhibitors, due to an increased risk for rhabdomyolysis
- B. Bile-acid sequestering resins, due to interference with folic acid absorption
- C. Grapefruit juice, due to interference with metabolism
- D. Niacin, due to decreased gemfibrozil activity
Correct Answer: A
Rationale: Gemfibrozil with statins increases rhabdomyolysis risk.
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A nurse is required to give an intramuscular (IM) injection to an 18-month-old toddler. The nurse would prepare which site for administration?
- A. Dorsogluteal site
- B. Deltoid muscle
- C. Vastus lateralis
- D. Ventrogluteal site
Correct Answer: C
Rationale: The vastus lateralis site is frequently used for infants and small children because it is more developed than the other intramuscular sites such as the dorsogluteal and deltoid muscle. Ventrogluteal sites may be used in children who have been ambulating for more than 2 years.
Choose an antihypertensive agent that is most likely to produce tachycardia, fluid retention and hirsutism?
- A. Captopril
- B. Guanethidine
- C. Minoxidil
- D. Prazosin
Correct Answer: C
Rationale: Minoxidil causes reflex tachycardia, fluid retention, and hirsutism.
No physical dependence is seen in:
- A. Dextropropoxyphene
- B. Fortwin
- C. Fluoxetine
- D. Alprax
Correct Answer: C
Rationale: Fluoxetine (SSRI) has no physical dependence; others do.
The nurse, assisting with Phase I drug studies, is talking with a woman who asks, Why can't I participate in this study? What would be the nurse's best response?
- A. Drugs pose a greater risk to women of reproductive age.
- B. Drugs are only tested on men because they are stronger.
- C. Women are more prone to adverse effects from medications.
- D. Drugs affect women differently than they affect women.
Correct Answer: A
Rationale: Phase I drug trials usually involve healthy male volunteers because chemicals may exert an unknown and harmful effect on ova in women which could result in fetal damage when the woman becomes pregnant. Drugs are tested on both men and women, but women must be fully informed of risks and sign a consent stating they understand the potential for birth defects. Women are not more prone to adverse effects of medications. Although some drugs may affect women differently than men, this is a rationale for why drugs need to be tested on women, not an explanation of why women are not included in a phase I study.
The nurse, working on the maternity unit, receives a call from a pregnant woman asking how she can know whether a medication is safe to take while pregnant. What is the nurses best response?
- A. You can take any drug indicated as a Category A.
- B. No medications should be taken during pregnancy.
- C. Never take medication until you receive approval from your health care provider.
- D. Most medications are safe but you need to weigh benefit against risk.
Correct Answer: C
Rationale: The best response to a pregnant woman asking about medication usage is to talk with her obstetric practitioner because the best advice will come from someone who knows their health and pregnancy history. While Category A drugs have no known risk, they may be contraindicated by the woman's health condition or pregnancy issues and many pregnant women would not know what it means to be a Category A drug. Medications can be helpful during pregnancy if taken safely and appropriately. Although risk benefit needs to be weighed, it should occur with advice from the obstetric practitioner.