Nokea
One of the patient in the clinic is being treated with spironolactone. Which statement correctly describes a property of this drug?
- A. Contraindicated in heart failure, especially if severe
- B. Inhibits sodium reabsorption in the proximal tubules
- C. Interferes with aldosterone synthesis
- D. Is generally preferred to a thiazide in most patients with essential hypertension
Correct Answer: C
Rationale: Spironolactone blocks aldosterone receptors, not synthesis; correct answer inferred as none fully match.
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A nurse is providing teaching to a client who has a new prescription for Amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching?
- A. Expect therapeutic effects in 24 to 48 hr.
- B. Discontinue the medication after a week of improved mood.
- C. Change positions slowly to minimize dizziness.
- D. Decrease injury from the first dose.
Correct Answer: C
Rationale: Slow position changes prevent dizziness, and chewing gum relieves dry mouth, common with tricyclics like amitriptyline.
A patient has been using sleeping pills every night for the past several months. Now admitted to the hospital, he is prescribed his usual dose of sleeping pill. After administration, the patient continues to be restless and is wide awake. The nurse notifies the health care provider, who prescribes an increased dose. After receiving the new dose, the patient falls asleep. The nurse interprets this as which of the following?
- A. Drug idiosyncrasy
- B. Cumulative drug effect
- C. Drug tolerance
- D. Toxic reactions
Correct Answer: C
Rationale: The patient has developed drug tolerance and has to be administered an increased dosage of the drug to achieve the desired effect. Cumulative drug effect occurs when the body is unable to metabolize and excrete one (normal) dose of a drug before the next dose is given. Drug idiosyncrasy is a term used to describe any unusual or abnormal reaction to a drug. Toxic reactions are caused when blood concentration levels exceed the therapeutic levels of a drug.
The following drug may be used in the management of acromegaly:
- A. Leuprolide
- B. Octreotide
- C. Cosyntropin
- D. Desmopressin
Correct Answer: B
Rationale: Octreotide, a somatostatin analog, inhibits growth hormone in acromegaly.
Drug levels should be monitored in the treatment of
- A. Diabetes
- B. Epilepsy
- C. Status Asthmatics
- D. Hypertension
Correct Answer: B
Rationale: Therapeutic drug monitoring is critical in epilepsy (e.g., phenytoin) due to narrow therapeutic ranges.
A nurse is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol?
- A. Asthma
- B. Glaucoma
- C. Hypertension
- D. Tachycardia
Correct Answer: A
Rationale: Propranolol is contraindicated in asthma due to risk of bronchoconstriction.