Nokea
Release of the mineralcorticoids is stimulated with:
- A. Low concentration of \mathrm{Na}+ in the blood
- B. Hypokalemia
- C. Low concentration of angiotensin II in the blood
- D. Low concentration of \mathrm{Mg} 2+ in the blood
Correct Answer: A
Rationale: Low blood sodium stimulates aldosterone release via the renin-angiotensin system.
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Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is:
- A. Black tarry stools
- B. Vomiting
- C. Tremors
- D. Tinnitus
Correct Answer: D
Rationale: Tinnitus is an early aspirin toxicity sign; black stools or vomiting are later.
A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. After reaching the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.
How can the nurse find the most up-to-date information about emergency preparedness related to bioterrorism agents?
- A. Read textbooks devoted to the topic.
- B. Ask coworkers to explain current events.
- C. Read journal articles about bioterrorism agents.
- D. Visit the Centers for Disease Control and Prevention (CDC) Web site.
Correct Answer: D
Rationale: The most current information will be found on the CDC Web site because new information can be posted immediately whereas textbooks and journal articles take time to print. Coworkers may or may not remain current on emergency preparedness and should not be the primary source of information.
Drugs significantly affected by enzyme induction include the following except:
- A. Barbiturate
- B. Chlorpromazine
- C. Diphenyl hydantoin
- D. Warfarin
Correct Answer: B
Rationale: Barbiturates, phenytoin (diphenyl hydantoin), and warfarin are affected by enzyme induction; chlorpromazine is less so.
Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?
- A. A 35-year-old woman with cervical cancer
- B. A 41-year-old man with kidney stones
- C. A 50-year-old man with cirrhosis of the liver
- D. A 62-year-old woman in acute renal failure
Correct Answer: C
Rationale: The liver is the most important site of drug metabolism. If the liver is not functioning effectively, as in patients with cirrhosis, drugs will not metabolize normally so that toxic levels could develop unless dosage is reduced. A patient with cervical cancer or kidney stones would not be expected to have altered ability to metabolize drugs so long as no liver damage existed. The patient with renal failure would have altered excretion of the drugs through the renal system but metabolism would not be impacted.