Nokea
Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:
- A. Substitutes for insulin usually secreted by the pancreas
- B. Decreases glycogenolysis by the liver
- C. Increases the release of insulin from beta cells
- D. Decreases peripheral glucose utilization
Correct Answer: B
Rationale: Metformin reduces hepatic glucose output (glycogenolysis), key in type 2 diabetes; it doesn't mimic insulin or increase release .
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Which of the following shows high first pass metabolism:
- A. Propranolol
- B. Phenobarbitone
- C. Phenylbutazone
- D. Phenytoin
Correct Answer: A
Rationale: Propranolol undergoes extensive first-pass metabolism in the liver.
A nurse is assessing a pregnant client and learns that the client is addicted to cocaine. The nurse informs the client about the risks of cocaine addiction for her fetus. Which of the following would the nurse include?
- A. The child may be born with diabetes.
- B. The child may be born with hypertension.
- C. The child may be born with an addiction to drugs.
- D. The child may be born with CNS defects.
Correct Answer: C
Rationale: The nurse informs the client that children born to mothers using addictive drugs are often born with an addiction to the drug. Children born to mothers who are addicted to cocaine are not known to be born with diabetes, CNS defects, or hypertension.
Data in the electronic health record that the provider reviews prior to a patient encounter varies with the clinic setting. In an urgent care clinic, the provider should review:
- A. The patient's current diagnosis and history
- B. Drugs the patient is currently taking
- C. Any recent previous encounter for the same problem as this visit and what was done
- D. All of the above
Correct Answer: D
Rationale: In urgent care, reviewing diagnosis, medications, and prior encounters ensures comprehensive care.
The following class of drugs may be used to treat Parkinsonian syndrome arising from the use of phenothiazines:
- A. Nicotinic receptor antagonists
- B. Muscarinic receptor antagonists
- C. Adrenoceptor antagonists
- D. Anticholinesterases
Correct Answer: B
Rationale: Antimuscarinics (e.g., benztropine) relieve parkinsonism from phenothiazines.
Glibenclamide and chlorpropamide:
- A. Are well absorbed in Gl tract
- B. Increase release of endogenic insulin by pancreatic beta cells
- C. Is used as hormone replacement therapy for diabetes mellitus
- D. Is for internal use only
Correct Answer: B
Rationale: Glibenclamide and chlorpropamide increase endogenous insulin release from beta cells.