Nokea
Serum digoxin levels are monitored for potential toxicity. Monitoring should occur:
- A. Within 6 hours of the last dose
- B. Because a reference point is needed in adjusting a dose
- C. After three half-lives from the starting of the drug
- D. When a patient has stable renal function
Correct Answer: C
Rationale: Monitoring after three half-lives (steady state) ensures accurate therapeutic levels.
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A 24-year-old male received multiple fractures in a motor vehicle accident that required significant amounts of opioid medication to treat his pain. He is at risk for a __ adverse drug reaction when he no longer requires the opioids.
- A. Rapid
- B. First-dose
- C. Late
- D. Delayed
Correct Answer: A
Rationale: Opioid withdrawal after heavy use is a Type E (end-of-use) ADR, but 'Rapid' fits the abrupt cessation context here, though not standard typology.
A 57-year-old man was recently diagnosed with Type-2 diabetes mellitus and placed on a medication. He began having myalgias and feeling sick and later developed respiratory distress, so he went to the hospital. His pH was 7.2, and he had elevated blood lactate levels. Which drug is likely causing his problem?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin can cause lactic acidosis, a rare but serious side effect, presenting with low pH and elevated lactate levels.
A nurse is assessing a client who is taking Amiodarone to treat Atrial Fibrillation. Which of the following findings is a manifestation of Amiodarone toxicity?
- A. Light yellow urine
- B. Report of tinnitus
- C. Productive cough
- D. Blue-gray skin discoloration
Correct Answer: C
Rationale: Productive cough may indicate pulmonary toxicity, a serious amiodarone side effect.
The adverse event of thiazolidinedione's is:
- A. Water retention and edema
- B. Weight loss
- C. Facilitation of rhinitis and upper respiratory tract infection
- D. Pancreatitis
Correct Answer: A
Rationale: Thiazolidinediones like pioglitazone cause water retention and edema, increasing heart failure risk.
Patients who are prescribed olanzapine (Zyprexa) should be monitored for:
- A. Insomnia
- B. Weight gain
- C. Hypertension
- D. Galactorrhea
Correct Answer: B
Rationale: Olanzapine commonly causes significant weight gain.