Nokea
Nicotine has a variety of effects on nicotinic receptors throughout the body. Which of the following is NOT an effect of nicotine?
- A. Vasodilation and decreased heart rate
- B. Increased secretion of gastric acid and motility of the GI smooth muscle
- C. Release of dopamine at the pleasure center
- D. Stimulation of the locus coeruleus
Correct Answer: A
Rationale: Nicotine causes vasoconstriction and increased heart rate, not vasodilation.
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The hypoglycemic mechanism of action of pioglitazone and rosiglitazon is:
- A. They are peroxisome proliferator activating receptor gamma (PPAR-Y) ligands and enhance absorption of glucose and fatty acid
- B. Enhance closure of ATP sensitive K+ channels and entrance of calcium in intracellular efflux via Ca2+ channels
- C. Decrease gluconeogenesis in the liver
- D. Increase tyrosine kinase activity
Correct Answer: A
Rationale: Pioglitazone and rosiglitazone activate PPAR-gamma, improving insulin sensitivity and glucose uptake in tissues.
What must the nurse have before administering any medication? (Select one that does not apply.)
- A. A current license to practice
- B. A medication order signed by a practitioner licensed with prescription privileges
- C. Knowledge of the medication
- D. Consultation with a pharmacist
Correct Answer: D
Rationale: Physicians must be licensed to prescribe medications; nurses must be licensed to administer medications. Safe medication administration includes knowledge of the medication, pathophysiology of patient diagnoses, and pharmacodynamics of the ordered medication on the pathophysiology. It is not necessary for the nurse to consult with a pharmacist each time medication is to be administered to a patient.
Which of the following statements about Thalidomide is INCORRECT?
- A. It is anti angiogenic
- B. It is anti inflammatory
- C. It is immunomodulatory
- D. It is mitogenic
Correct Answer: D
Rationale: Thalidomide is not mitogenic; it inhibits cell proliferation.
A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no side effects. Since her move, however, she reports having 'dizzy spells and weakness' and feels that the drug is no longer effective. The nurse knows that one possible reason for the change in the effectiveness of the drug could be which of the following?
- A. The impact of the placebo effect on the patient's response
- B. The accumulative effect of the drug if it has been taken for many years
- C. The impact of the warmer environment on the patient's physical state
- D. Problems with patient compliance with the drug regimen while on vacation
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and enters a warmer climate, there is a chance that the patient's blood pressure will drop too low, resulting in dizziness and feelings of weakness. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen while on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?
- A. Contact provider if heart rate is less than 60/min.
- B. Check pulse rate for 30 seconds and multiply result by 2.
- C. Increase intake of sodium.
- D. Take with food if nausea occur
Correct Answer: A
Rationale: Bradycardia (<60/min, A) is a sign of digoxin toxicity to report; pulse should be checked for 1 minute.