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 low-carbohydrate, high-protein diet may:
- A. Increase drug-metabolizing enzymes
- B. Decrease drug absorption from the GI tract
- C. Alter drug binding to plasma proteins
- D. Enhance drug elimination
Correct Answer: A
Rationale: High-protein diets can induce hepatic enzymes (e.g., CYP450), increasing drug metabolism.
Carvedilol is heavily metabolized by CYP2D6 and 2C9, resulting in drug interactions with which of the following drug classes?
- A. Histamine 2 blockers
- B. Quinolones
- C. Serotonin re-uptake inhibitors
- D. All of the above
Correct Answer: C
Rationale: SSRIs inhibit CYP2D6, increasing carvedilol levels and effects.
A 6 year old child was admitted to the emergency unit with suspicion of an accidental overdose of chlordiazepoxide. Which of the following antagonists may be administered as part of the initial treatment?
- A. Flumazenil
- B. Naloxone
- C. Fomepizole
- D. Nalorphine
Correct Answer: A
Rationale: Flumazenil reverses benzodiazepine (e.g., chlordiazepoxide) overdose.
What is the most reliable method to calculate a pediatric patient's medication dosage?
- A. Age
- B. Height
- C. Body surface area (BSA)
- D. Placement on a growth scale
Correct Answer: C
Rationale: The most reliable method is by proportional amount of BSA or body weight. Because of the differences in weight among children, age is not a reliable method. Because of the differences in height among children, this is not a reliable method. Placement on a growth scale identifies how the child corresponds to other children on a percentile. Although it is determined by a specific measurement, the percentile identified would not be a specific measurement; therefore, this is not a reliable method.
The nurse observes that after administration of a drug the patient has developed itching and a skin rash. The nurse interprets these findings as which of the following?
- A. Toxicity
- B. Allergic reaction
- C. Angioedema
- D. Crystalluria
Correct Answer: B
Rationale: Allergic reactions are manifested by a variety of signs and symptoms including itching, skin rashes, and hives. Swollen eyelids, lips, and mouth are some of the symptoms of angioedema, an allergic drug reaction that may block the airway, causing asphyxia. Toxicity or toxic reactions are caused when blood concentration levels exceed the therapeutic level of drugs. Reduced blood pressure is called hypotension. Crystals in the urine are symptoms of crystalluria.