Nokea
Patients whose total dose of prednisone will exceed 1 gram will most likely need a second prescription for:
- A. Metformin, a biguanide to prevent diabetes
- B. Omeprazole, a proton pump inhibitor to prevent peptic ulcer disease
- C. Naproxen, an NSAID to treat joint pain
- D. Furosemide, a diuretic to treat fluid retention
Correct Answer: B
Rationale: High-dose prednisone risks ulcers, warranting omeprazole; diabetes or fluid are less immediate.
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Which of the following medications is classified as a Class IA antiarrhythmic?
- A. Amiodarone
- B. Quinidine
- C. Sotalol
- D. Diltiazem
Correct Answer: B
Rationale: Quinidine is a Class IA antiarrhythmic, blocking sodium channels and prolonging the action potential.
Which of the following are poorly perfused tissues?
- A. Heart
- B. Brain
- C. Liver
- D. Kidneys
Correct Answer: B
Rationale: This appears to be a trick question; heart, brain, liver, and kidneys are well-perfused. Assuming intent was poorly perfused, none fit, but B (Brain) is least correct here as it's well-perfused.
A group of nursing students are reviewing information about drug development in the United States in preparation for an exam. The students demonstrate understanding of this material when they identify testing of which of the following as one of the first steps?
- A. Small group of healthy volunteers
- B. People who have the disease
- C. Live animals
- D. Large numbers of patients
Correct Answer: C
Rationale: Initially, drug testing begins with testing in an artificial environment such as a test tube, and then this testing is followed by testing on live animals. Next, clinical testing occurs with each phase involving a larger number of people. First, a small group of 20 to 100 healthy volunteers are tested; then testing is performed on people who have the disease or condition. Last, the drug is given to large numbers of patients in medical research centers.
Laboratory monitoring for patients on angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers should include:
- A. White blood cell counts with the drug dosage increased for elevations above 10,000 feet
- B. Liver function tests with the drug dosage stopped for alanine aminotransferase values twice that of normal
- C. Serum creatinine levels with the drug dosage reduced for values greater than 2.5 mg/dL
- D. Serum glucose levels with the drug dosage increased for levels greater than 120 mg/dL
Correct Answer: C
Rationale: Elevated creatinine (>2.5 mg/dL) indicates renal impairment, requiring dose adjustment.
A nurse is administering a Dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication?
- A. Lowered heart rate
- B. Increased myocardial contractility
- C. Decreased conduction through the AV node
- D. Vasoconstriction of renal blood vessel
Correct Answer: B
Rationale: Low-dose dopamine increases contractility via beta-adrenergic effects, improving cardiac output.