Nokea
Mechanisms of transmembrane signaling are the following EXCEPT:
- A. Transmembrane receptors that bind and stimulate a protein tyrosine kinase
- B. Gene replacement by the introduction of a therapeutic gene to correct a genetic effect
- C. Ligand-gated ion channels that can be induced to open or close by binding a ligand
- D. Transmembrane receptor protein that stimulates a GTP-binding signal transducer protein (G-protein) which in turn generates an intracellular second messenger
Correct Answer: B
Rationale: Gene replacement is a therapeutic strategy, not a signaling mechanism.
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Elderly patients who are started on levothyroxine for hypothyroidism may experience which of the following as a side effect that would require reevaluation of dosage?
- A. Excessive sedation
- B. Tachycardia and angina
- C. Weight gain
- D. Cold intolerance
Correct Answer: B
Rationale: Levothyroxine can cause tachycardia and angina in the elderly if overdosed; sedation or weight gain suggest underdosing.
Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
- A. OTC drugs are always safe and will not cause bad effects.'
- B. OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).'
- C. OTC drugs are different from any drugs available by prescription and cost less.'
- D. OTC drugs are thought to be safe when taken as directed.'
Correct Answer: D
Rationale: OTC drugs are drugs that have been determined to be safe when taken as directed. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC education should always be included as a part of the hospital discharge instructions.
A 52-year-old overweight woman presents to the clinic for a diabetes management. She had not been doing well controlling her blood sugars with metformin. Her last hemoglobin A1c was 13.4%, despite her taking her medication every day. The physician decides to start her on a long-acting insulin that is injected only once a day for better glucose control. Also, he wants the insulin to have a minimal risk of hypoglycemia. What is the most likely medication given to this patient?
- A. Insulin aspart
- B. Insulin glargine
- C. Insulin lispro
- D. NPH insulin
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin administered once daily, with a lower risk of hypoglycemia compared to other insulins.
The nurse admits a patient to the unit and learns the patient has recently been diagnosed with chronic renal failure but has not informed the primary care provider of this diagnosis. What is the nurse's first priority?
- A. Administer medications ordered immediately.
- B. Maintain the patient's confidentiality.
- C. Call the admitting physician immediately.
- D. Provide teaching about chronic renal failure
Correct Answer: C
Rationale: Renal failure affects drug clearance; informing the physician ensures safe therapy adjustments.
After teaching a group of nursing students about pharmacokinetics, the instructor determines that the teaching was successful when the students identify which of the following as the first phase?
- A. Metabolism
- B. Absorption
- C. Distribution
- D. Excretion
Correct Answer: B
Rationale: Pharmacokinetics refers to the transportation activity of drugs in the body after administration. The first component is absorption. This is followed by distribution, metabolism, and finally excretion.