Methylnaltrexone is used to treat constipation in:
- A. Patients with functional constipation
- B. Patients with irritable bowel syndrome-associated constipation
- C. Children with encopresis
- D. Opioid-associated constipation
Correct Answer: D
Rationale: Methylnaltrexone specifically reverses opioid-induced constipation; it's not for functional , IBS , or pediatric use.
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A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
- A. Prednisone
- B. Phenelzine (Nardil)
- C. Atenolol (Tenormin)
- D. Allopurinol (Zyloprim)
Correct Answer: A
Rationale: Prednisone may decrease the effect of oral hypoglycemics, insulin, diuretics, and potassium supplements. Option 2, a monoamine oxidase inhibitor, and option 3, a β-blocker, have their own intrinsic hypoglycemic activity. Option 4 decreases urinary excretion of sulfonylurea agents, causing increased levels of the oral agents, which can lead to hypoglycemia.
Research has shown that when patients who are covered by Medicare Part D reach the 'donut hole' in coverage they:
- A. Ask for extra refills of medication to get them through the months of no coverage
- B. Fill their prescriptions less frequently, including critical medications such as warfarin or a statin
- C. Fill their critical medications, but hold off on filling less-critical medications
- D. Demonstrate no change in their prescription filling pattern
Correct Answer: B
Rationale: Patients reduce prescription filling, even for critical drugs, during the donut hole.
When completing the check to ensure that the right drug is being administered to the client, which of the following should the nurse compare?
- A. Medication
- B. Container label
- C. Medication record
- D. All the above
Correct Answer: D
Rationale: The nurse compares the medication, container label, and medication record and then the MAR as the item is removed from the cart and before the actual administration of the drug.
A nurse is assessing the patients home medication use. After listening to the patient list current medications, the nurse asks what priority question?
- A. Do you take any generic medications?
- B. Are any of these medications orphan drugs?
- C. Are these medications safe to take during pregnancy?
- D. Do you take any over-the-counter medications?
Correct Answer: D
Rationale: It is important for the nurse to specifically question use of over-the-counter medications because patients may not consider them important. The patient is unlikely to know the meaning of orphan drugs unless they too are health care providers. Safety during pregnancy, use of a generic medication, or classification of orphan drugs are things the patient would be unable to answer but could be found in reference books if the nurse wishes to research them.
If 10 mg of naproxen produces the same analgesic response as 100 mg of ibuprofen, which of the following statements is correct?
- A. Naproxen is more efficacious than is ibuprofen
- B. Naproxen is more potent than ibuprofen
- C. Naproxen is full agonist, and ibuprofen is a partial agonist
- D. Naproxen is a competitive antagonist
Correct Answer: B
Rationale: Lower dose for the same effect indicates naproxen is more potent (lower EC50) than ibuprofen.