NSAIDs should be avoided in which group(s) of patients?
- A. Kidney disease
- B. Myocardial infarction
- C. Irritable bowel syndrome
- D. All of the above
Correct Answer: D
Rationale: NSAIDs can worsen kidney function, increase cardiovascular risk, and exacerbate GI conditions, making them risky for all listed groups.
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Administration of exenatide is by subcutaneous injection:
- A. 30 minutes prior to the morning meal
- B. 60 minutes prior to the morning and evening meal
- C. 15 minutes after the evening meal
- D. 60 minutes before each meal daily
Correct Answer: B
Rationale: Exenatide is injected 60 minutes before morning and evening meals to optimize glucose control; timing is incorrect.
Which of the following is an advantage of sublingual administration?
- A. Rapid absorption
- B. Convenient
- C. Avoid harsh GI environment
- D. Avoid first pass-metabolism
Correct Answer: D
Rationale: Sublingual administration offers rapid absorption , convenience , avoids the GI tract , and bypasses first-pass metabolism ; all are true, but D is a key pharmacological advantage.
Which of the following legislative acts allowed the Food and Drug Administration (FDA) to tighten control over the quality of drugs and required that safety and efficacy standards be established?
- A. Pure Food and Drug Act of 1906
- B. Federal Food, Drug, and Cosmetic Act of 1938
- C. Durham Humphrey Amendment of 1951
- D. Kefauver-Harris Act of 1962
Correct Answer: D
Rationale: The Kefauver-Harris Act was the result of the use of the 1960s drug thalidomide (Thalomid). The public concern led to the legislation that gave the FDA regulatory control over testing and evaluating of drugs and allowed it to set standards for efficacy and safety. The Pure Food and Drug Act required labeling to eliminate false claims. The Federal Food, Drug, and Cosmetic Act gave the FDA the power to enforce standards for testing drug toxicity and monitoring labeling. The Durham-Humphrey Amendment enforced prescriptions for distribution.
The nursing assessment identifies that the client is nauseated and cannot take acetaminophen (Tylenol) orally. Which is true regarding the substitution of this medication to suppository form?
- A. It is standard practice when the patient is unable to take the ordered medication.
- B. It is acceptable if the patient agrees to the altered route form.
- C. It is preferable to having the patient miss a dose of the medication.
- D. It is contraindicated without an order from the health care provider.
Correct Answer: D
Rationale: One dosage form of medication should never be substituted for another unless the prescriber is consulted; there can be a great variation in the absorption rate of the medication through different routes of administration. The substitution of one form for another is not standard practice, and is not acceptable or preferable without the prescriber's order.
Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first?
- A. Patients with kidney stones
- B. Pregnant patients
- C. Patients with heartburn
- D. Postmenopausal women
Correct Answer: A
Rationale: Calcium carbonate can worsen kidney stones; it's generally safe in pregnancy or heartburn without special caution.