Mary has a two-tiered prescription benefit plan, which means:
- A. She can receive differing levels of care based on whether she chooses an 'in-plan' provider or not.
- B. She is eligible for the new Medicare Part D 'donut hole' reduction of costs program.
- C. She pays a higher copay for brand-name drugs than for generic drugs.
- D. She must always choose to be treated with generic drugs first.
Correct Answer: C
Rationale: A two-tiered plan typically involves higher copays for brand-name drugs.
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A nurse working in radiology administers iodine to a patient who is having a computed tomography (CT) scan. The nurse working on the oncology unit administers chemotherapy to patients who have cancer. At the Public Health Department, a nurse administers a measles-mumps-rubella (MMR) vaccine to a 14-month-old child as a routine immunization. Which branch of pharmacology best describes the actions of all three nurses?
- A. Pharmacoeconomics
- B. Pharmacotherapeutics
- C. Pharmacodynamics
- D. Pharmacokinetics
Correct Answer: B
Rationale: Pharmacology is the study of the biologic effects of chemicals. Nurses are involved with clinical pharmacology or pharmacotherapeutics, which is a branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. The radiology nurse is administering a drug to help diagnose a disease. The oncology nurse is administering a drug to help treat a disease. Pharmacoeconomics includes any costs involved in drug therapy. Pharmacodynamics involves how a drug affects the body and pharmacokinetics is how the body acts on the body.
Which of the following drug increase the sensitivity of fatty tissue and muscles towards insulin:
- A. Dapagliphlozin
- B. Miglitol
- C. Nateglinide
- D. Rosiglitasone
Correct Answer: D
Rationale: Rosiglitazone, a thiazolidinedione, enhances insulin sensitivity in fat and muscle via PPAR-gamma activation.
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.
Paracetamol is an NSAID with a comparatively low anti-inflammatory effect compared to other NSAIDs.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Paracetamol (acetaminophen) has minimal anti-inflammatory activity, primarily acting as an analgesic and antipyretic.
A patient has a drug level of 50 units/mL and the drug's half-life is 1 hour. If concentrations above 25 units/mL are considered toxic and no more drug is given, how long will it take for the blood level to reach the nontoxic range?
- A. 30 minutes
- B. 1 hour
- C. 2 hours
- D. 3 hours
Correct Answer: C
Rationale: Half-life is the time required for the serum concentration of a drug to decrease by 50%. After 1 hour, the serum concentration would be 25 units/mL (50/2). After 2 hours, the serum concentration would be 12.5 units/mL (25/2) and reach the nontoxic range.
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