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Prior to prescribing metformin, the provider should:
- A. Draw a serum creatinine to assess renal function
- B. Try the patient on insulin
- C. Tell the patient to increase iodine intake
- D. Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions
Correct Answer: A
Rationale: Metformin requires renal function assessment (creatinine) due to lactic acidosis risk; insulin isn't a prerequisite.
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Immunosupressive effects of glucocorticoids are denominated with:
- A. Decrease of interleukins 1,2
- B. Activation of lymphocyte proliferation
- C. Increase amount of T lymphocytes
- D. Activation of lymphocyte transport at the site of antigen stimulation
Correct Answer: A
Rationale: Glucocorticoids suppress immunity by decreasing pro-inflammatory cytokines like interleukins 1 and 2.
Janice has elevated LDL, VLDL, and triglyceride levels. Niaspan, an extended-release form of niacin, is chosen to treat her hyperlipidemia. Due to its metabolism and excretion, which of the following laboratory results should be monitored?
- A. Serum alanine aminotransferase
- B. Serum amylase
- C. Serum creatinine
- D. Phenylketonuria
Correct Answer: A
Rationale: Niacin can cause hepatotoxicity, requiring ALT monitoring.
A nurse is caring for a patient who is supposed to receive two drugs at the same time. What is the nurse's priority action?
- A. Wash her hands before handling the medications.
- B. Consult a drug guide for compatibility.
- C. Question the patient concerning drug allergies.
- D. Identify the patient by checking the armband and asking the patient to state his name.
Correct Answer: B
Rationale: A nurse should first consult a drug guide for compatibility when two or more drugs are being given at the same time. After compatibility is determined the medication can be administered. The nurse will perform hand hygiene, check for patient allergies, and ensure the right patient receives the medication by using two identifiers.
Information technology (IT) can also be used to interact with a patient between encounters. Which of the following statements about such interactions is true?
- A. Patients feel the provider does not care about them if they are not seen in a face-to-face encounter.
- B. Data collected from patients between encounters via IT is less accurate and complete.
- C. Collecting data between encounters via IT may mean a more efficient face-to-face encounter.
- D. Between encounters is a good time to collect screening data.
Correct Answer: C
Rationale: IT-collected data between encounters can streamline subsequent in-person visits.
Km value indicates
- A. Purity of enzyme
- B. Physiological role
- C. Half life enzyme drug complex
- D. Affinity
Correct Answer: C
Rationale: Km (Michaelis constant) reflects the substrate concentration at half-maximum velocity, indicating enzyme-drug complex half-life.