Nokea
Protein binding of a drug helps in
- A. Distribution
- B. Prolonging half life
- C. Limiting metabolism
- D. All of the above
Correct Answer: D
Rationale: Protein binding affects distribution (bound drugs stay in plasma), prolongs half-life (less free drug available for clearance), and limits metabolism (bound drug is less accessible to enzymes).
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A physician has ordered intramuscular injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug, therefore, morphine is categorized as a:
- A. Schedule I drug
- B. Schedule II drug
- C. Schedule III drug
- D. Schedule IV drug
Correct Answer: B
Rationale: Narcotics such as morphine are considered schedule II drugs because of the high abuse potential with severe dependence liability. Schedule I drugs have high abuse potential and no accepted medical use. Schedule III drugs have a lesser abuse potential than schedule II drugs and an accepted medical use. Schedule IV drugs have low abuse potential and limited dependence liability.
The action of 'gliptins' is different from other antidiabetic agents because they:
- A. Have a low risk for hypoglycemia
- B. Are not associated with weight gain
- C. Close ATP-dependent potassium channels in the beta cell
- D. Act on the incretin system to indirectly increase insulin production
Correct Answer: D
Rationale: Gliptins enhance incretin activity, boosting insulin secretion without hypoglycemia risk , unlike sulfonylureas .
The nurse is talking with a group of nursing students who are doing clinical hours on the unit. A student asks if all intramuscular (IM) drugs are absorbed the same. What factor would the floor nurse tell the students to affect absorption of the IM administration of drugs?
- A. Perfusion of blood to the subcutaneous tissue
- B. Integrity of the mucous membranes
- C. Environmental temperature
- D. Blood flow to the gastrointestinal tract
Correct Answer: C
Rationale: A cold environmental temperature can cause blood vessels to vasoconstrict and decreases absorption or in a hot environment vasodilate and increase absorption of IM medications. Blood flow to the subcutaneous tissues interferes with subcutaneous injection and blood flow to the gastrointestinal (GI) tract causes alterations in absorption for oral medications. The condition of mucous membranes can interfere with sublingual (under the tongue) and buccal (in the cheek) administration of drugs.
Which classification does meperidine (Demerol) fall under?
- A. I
- B. II
- C. III
- D. IV
Correct Answer: B
Rationale: Meperidine (Demerol) is a Schedule II drug; it has a high potential for abuse and may lead to severe psychological and physical dependence.
An order is written for a patient to receive 1000 mL of normal saline IV over 8 hours. If the IV infusion set is a microdrip set that delivers 60 drops/mL, how many drops per minute should the patient be receiving?
- A. 60 drops/min
- B. 120 drops/min
- C. 240 drops/min
- D. 480 drops/min
Correct Answer: B
Rationale: If a patient were to receive 1000 mL in 8 hours, dividing 1000 by 8 would mean that the patient would receive 125 mL in 1 hour, or 60 minutes. Setting up the equation, 60 drops/mL X = 125 mL/60 min, and cross-multiplying, the answer is 120 drops/min.