Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for:
- A. Hypokalemia
- B. Impotence
- C. Decreased renal function
- D. Inability to concentrate
Correct Answer: C
Rationale: ACE inhibitors can worsen renal function, necessitating baseline assessment.
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Strategies prescribers can use to prevent misuse of controlled prescription drugs include:
- A. Use of chemical dependency screening tools
- B. Firm limit-setting regarding prescribing controlled substances
- C. Practicing 'just say no' to deal with patients who are pushing the provider to prescribe controlled substances
- D. All of the above
Correct Answer: D
Rationale: All strategies "screening , limits , and refusal "help prevent misuse of controlled substances.
Selma, who is overweight, recently started taking topiramate for seizures and at her follow-up visit you note she has lost 3 kg. The appropriate action would be:
- A. Tell her to increase her caloric intake to counter the effects of the topiramate.
- B. Consult with a neurologist, as this is not a common adverse effect of topiramate.
- C. Decrease her dose of topiramate.
- D. Reassure her that this is a normal side effect of topiramate and continue to monitor her weight.
Correct Answer: D
Rationale: Weight loss is a common, beneficial side effect of topiramate.
Slow channel syndrome is due to
- A. Accumulation of Na+ ions in channels
- B. Accumulation of K+ ions in channels
- C. Accumulation of Mg++ ions in channels
- D. Accumulation of Ca++ ions in channels
Correct Answer: D
Rationale: Slow channel syndrome relates to calcium channel dysfunction.
Which of the following inhibit production of triiodethyronine (T4) from tetraiodethyronine (T3)?
- A. Iodides
- B. Thiocyanate
- C. Perchlorate
- D. Amiodarone
Correct Answer: D
Rationale: Amiodarone inhibits the peripheral conversion of T4 to T3, reducing active thyroid hormone levels.
A patient wants to know about the possible interactions of the various drugs that he has been prescribed for an illness. The nurse explains that the drugs interact with each other and produce an effect that is greater than the sum of their separate actions. Which of the following reactions is the nurse informing about?
- A. Additive drug reaction
- B. Synergistic drug reaction
- C. Antagonistic drug reaction
- D. Toxic drug reaction
Correct Answer: B
Rationale: A synergistic drug reaction occurs when drugs interact with each other and produce a sum greater than the sum of their separate actions. An additive drug reaction occurs when the combined effect of two drugs is equal to the sum of each drug given alone. An antagonistic drug reaction occurs when one drug interferes with the action of another, causing neutralization or a decrease in the effect of one drug. Toxic drug reactions are caused when blood concentration levels exceed the therapeutic levels of a drug.
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