Nokea
Sally has been prescribed aspirin 320 mg per day for her atrial fibrillation. She also takes aspirin four or more times a day for arthritis pain. What are the symptoms of aspirin toxicity for which she would need to be evaluated?
- A. Tinnitus
- B. Diarrhea
- C. Hearing loss
- D. Photosensitivity
Correct Answer: A
Rationale: Tinnitus is an early sign of aspirin toxicity (salicylism); diarrhea or photosensitivity are less specific, and hearing loss is later.
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An overdose of amitriptyline may precipitate all the following adverse effects EXCEPT:
- A. Cardiac arrhythmias
- B. Hypotension
- C. Sedation
- D. Jaundice
Correct Answer: D
Rationale: Amitriptyline overdose does not typically cause jaundice; it causes anticholinergic and cardiac effects.
A non-competitive antagonist :
- A. Alters the mechanism of action of an agonist
- B. Alters the potency of an agonist
- C. Shifts the dose-response curve of an agonist to the right
- D. Decreases the maximum response to an agonist
Correct Answer: D
Rationale: Non-competitive antagonists reduce the maximal response (efficacy), not potency, distinguishing them from competitive antagonists.
You need to administer 200 mL of a drug over 30 minutes using microdrip tubing (60 gtt/mL). What is the flow rate in drops per minute?
- A. 60 gtt/min
- B. 120 gtt/min
- C. 400 gtt/min
- D. 240 gtt/min
Correct Answer: C
Rationale: Flow rate = (200 mL 60 gtt/mL) ÷ 30 = 12,000 ÷ 30 = 400 gtt/min, matching option C.
Rabi is being prescribed phenytoin for seizures. Monitoring includes assessing:
- A. For phenytoin hypersensitivity syndrome 3 to 8 weeks after starting treatment
- B. For pedal edema throughout therapy
- C. Heart rate at each visit and consider altering therapy if heart rate is less than 60 bpm
- D. For vision changes, such as red-green blindness, at least annually
Correct Answer: A
Rationale: Phenytoin hypersensitivity syndrome can occur 3-8 weeks post-initiation.
Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
- A. Toxic levels of warfarin building up
- B. Decreased response to warfarin
- C. Increased risk for significant drug interactions with warfarin
- D. Less risk of drug interactions with warfarin
Correct Answer: B
Rationale: VCORC1 mutations reduce warfarin's anticoagulant effect , requiring higher doses, not toxicity or interaction changes .