Nokea
Patients who are prescribed olanzapine (Zyprexa) should be monitored for:
- A. Insomnia
- B. Weight gain
- C. Hypertension
- D. Galactorrhea
Correct Answer: B
Rationale: Olanzapine commonly causes significant weight gain.
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Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should be used cautiously in what population:
- A. Older adults
- B. Hypertensive patients
- C. Infants
- D. All of the above
Correct Answer: D
Rationale: Sympathomimetic decongestants like phenylephrine can raise blood pressure or cause adverse effects in older adults, hypertensives, and infants.
Serum digoxin levels are monitored for potential toxicity. Monitoring should occur:
- A. Within 6 hours of the last dose
- B. Because a reference point is needed in adjusting a dose
- C. After three half-lives from the starting of the drug
- D. When a patient has stable renal function
Correct Answer: C
Rationale: Monitoring after three half-lives (steady state) ensures accurate therapeutic levels.
What needs to happen to the protein-drug complex for the drugs to reach the cells where the drug can act?
- A. The protein-drug complex must break itself into smaller pieces to enter the capillaries.
- B. The binding site on the protein picks up a chemical to make it soluble in the serum.
- C. The drug must break away from the protein-binding site and float freely.
- D. The drug must be dissolved in the plasma so it can enter the capillaries and then the tissues.
Correct Answer: C
Rationale: Most drugs are bound, to some extent, to proteins in the blood to be carried into circulation. The protein-drug complex is relatively large and cannot enter into capillaries and then into tissues to react. The drug must be freed from the protein's binding site at the tissues. This occurs without the introduction of another chemical or by dissolving in it plasma.
Scopolamine can be used to prevent the nausea and vomiting associated with motion sickness. The patient is taught to:
- A. Apply the transdermal disk at least 4 hours before the antiemetic effect is desired.
- B. Swallow the tablet 1 hour before traveling where motion sickness is possible.
- C. Place the tablet under the tongue and allow it to dissolve.
- D. Change the transdermal disk daily for maximal effect.
Correct Answer: A
Rationale: Scopolamine patches require 4 hours for onset, making preemptive application key.
A pharmaceutical lab states that a drug causes negative side effects in 3 of every 100 patients. To confirm this affirmation, another laboratory chooses 5 people at random who have consumed the drug. What is the probability that at least two experience side effects?
- A. 0.8687
- B. 0.1313
- C. 0.00847
- D. 0.0003
Correct Answer: C
Rationale: The probability of at least two experiencing side effects is P(X≥2) = 1 - [P(X=0) + P(X=1)]. Using binomial calculations: P(X=0) = 0.8687, P(X=1) = (5 choose 1) * 0.03 * 0.97^4 = 0.1342, so P(X≥2) = 1 - (0.8687 + 0.1342) = 0.00847, matching the document.