Nokea
Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling depressed and having 'strange' thoughts. The appropriate initial action would be:
- A. Increase her dose
- B. Assess for suicidal ideation
- C. Discontinue the medication immediately
- D. Decrease her dose to half then slowly titrate up the dose
Correct Answer: B
Rationale: Gabapentin can cause mood changes; assessing for suicidal ideation is the priority.
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Incorporating information technology (IT) into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the provider is using by:
- A. Turning the screen around so the patient can see material being recorded
- B. Not placing the computer screen between the provider and the patient
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: C
Rationale: Both actions reduce barriers and enhance patient comfort with IT use.
Which diuretic is classified as a thiazide?
- A. Furosemide
- B. Spironolactone
- C. Hydrochlorothiazide
- D. Mannitol
Correct Answer: C
Rationale: Hydrochlorothiazide is a thiazide diuretic, acting on the distal convoluted tubule, unlike furosemide (loop), spironolactone (potassium-sparing), or mannitol (osmotic).
What is the most likely mechanism for hip fracture in patients with glucocorticoid longterm treatment?
- A. Increased intestinal calcium absorption
- B. Increased sex hormone synthesis
- C. Inhibition of bone formation
- D. Osteoarthritis
Correct Answer: C
Rationale: Glucocorticoids inhibit bone formation by suppressing osteoblast activity, increasing osteoporosis and fracture risk.
Which statement is true about over-the-counter (OTC) drugs?
- A. They are not listed in the USP NF
- B. A prescription from a healthcare provider is needed
- C. They are sold without a prescription
- D. They are known only by their brand names
Correct Answer: C
Rationale: OTC medications do not require a prescription and are sold freely, listed in the USP NF, and known by both generic and brand names.
This graph shows the concentration-dependent effects of norepinephrine on arterial blood pressure, both alone, and in the presence of a fixed concentration of Drug X. Which type of antagonist is Drug X?
- A. Silent
- B. Non-competitive
- C. Competitive
- D. Chemical
Correct Answer: B
Rationale: A non-competitive antagonist reduces the maximal response without shifting the potency (EC50), as indicated by the answer key, likely showing a decreased maximum on the graph.