Pharmacokinetic changes in women's bodies that affect drug dosing include:
- A. Increased body fat
- B. Increased glomerular filtration rate in pregnancy
- C. Decreased gastric emptying
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because increased body fat (alters distribution), higher GFR in pregnancy (increases clearance), and slower gastric emptying (affects absorption) all change pharmacokinetics, impacting dosing. Choice A is incorrect alone as fat is one change. Choice B is wrong by itself because GFR is just part. Choice C is incorrect solo since gastric emptying is only one factor.
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A primary care NP is preparing to prescribe a fluoroquinolone for a patient who has a history of alcohol abuse that has caused liver damage. The NP should choose:
- A. norfloxacin.
- B. levofloxacin.
- C. gemifloxacin.
- D. ciprofloxacin.
Correct Answer: B
Rationale: The correct answer is B because levofloxacin has lower hepatic risk, safer for liver-damaged patients. Choices A, C, and D are incorrect (higher hepatic risk).
Drugs that use CYP 3A4 isoenzymes for metabolism may:
- A. Induce the metabolism of another drug
- B. Inhibit the metabolism of another drug
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: C
Rationale: Choice C is correct because CYP 3A4 drugs can induce (speed up) or inhibit (slow down) metabolism of other drugs sharing this pathway, affecting their levels and efficacy. Choice A is incorrect as it's only half the story—induction happens, but inhibition does too. Choice B is wrong because it misses induction potential. Choice D is incorrect since both effects are well-documented with CYP 3A4.
Strategies to avoid counterfeit drugs include:
- A. Purchasing from licensed pharmacies
- B. Checking drug packaging
- C. Avoiding online purchases from unverified sources
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because using licensed pharmacies (regulated supply), checking packaging (authenticity cues), and avoiding unverified online sources (high-risk) all prevent counterfeit drug use, per FDA advice. Choice A is incorrect alone as it's one strategy. Choice B is wrong by itself because packaging is just part. Choice C is incorrect solo since online avoidance is only one method.
The client is being taught about the use of sublingual nitroglycerin for chest pain. Which instruction should be provided?
- A. Swallow the tablet whole with water.
- B. Place the tablet under the tongue and let it dissolve.
- C. Chew the tablet and then swallow.
- D. Place the tablet between the cheek and gum.
Correct Answer: B
Rationale: The correct method for administering sublingual nitroglycerin is to place the tablet under the tongue and allow it to dissolve. This route of administration facilitates rapid absorption of the medication into the bloodstream, enabling quick relief of chest pain associated with angina or heart conditions. Choice A is incorrect because sublingual nitroglycerin should not be swallowed whole. Choice C is wrong as chewing the tablet can lead to the rapid release of the drug, causing adverse effects like headaches or dizziness. Choice D is also incorrect as the tablet should not be placed between the cheek and gum, but under the tongue for proper absorption.
Pharmacokinetic changes in women's bodies that affect drug dosing include:
- A. Increased body fat
- B. Increased glomerular filtration rate in pregnancy
- C. Decreased gastric emptying
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because increased body fat (alters distribution), higher GFR in pregnancy (increases clearance), and slower gastric emptying (affects absorption) all change pharmacokinetics, impacting dosing. Choice A is incorrect alone as fat is one change. Choice B is wrong by itself because GFR is just part. Choice C is incorrect solo since gastric emptying is only one factor.