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 caring for a client who has Atrial Fibrillation and a new prescription for Dabigatran to prevent development of Thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of Dabigatran?
- A. Vitamin k1
- B. Protamine
- C. Omeprazole
- D. Probenecid
Correct Answer: C
Rationale: Omeprazole reduces dabigatran's GI bleeding risk, a common side effect.
Pregnant women should receive the Tdap vaccine:
- A. In the first trimester
- B. Once every 10 years
- C. In the third trimester of every pregnancy
- D. Tdap is contraindicated in pregnancy
Correct Answer: C
Rationale: Tdap in the third trimester protects newborns from pertussis; it's not contraindicated or trimester-specific otherwise.
What is the entry of drugs into the plasma?
- A. Absorption
- B. Distribution
- C. Elimination
- D. Metabolism
Correct Answer: A
Rationale: Absorption is the process by which a drug enters the plasma from its administration site, the first step in pharmacokinetics.
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.
Patients who have a poor metabolism phenotype will have:
- A. Slowed metabolism of a prodrug into an active drug, leading to accumulation of prodrug
- B. Accumulation of inactive metabolites of drugs
- C. A need for increased dosages of medications
- D. Increased elimination of an active drug
Correct Answer: A
Rationale: Poor metabolizers (e.g., CYP2D6) slowly convert prodrugs to active forms , causing prodrug buildup, not metabolite accumulation or faster elimination .