Nokea
Spironolactone (Aldactone) acts at this nephron site:
- A. Proximal convoluted tubule
- B. Ascending thick limb of the loop of Henle
- C. Distal convoluted tubule
- D. Collecting duct
Correct Answer: D
Rationale: The correct answer is D: Collecting duct. Spironolactone is a potassium-sparing diuretic that acts on the aldosterone receptor in the collecting duct of the nephron. This inhibits sodium reabsorption and potassium secretion, leading to increased excretion of sodium and water while retaining potassium. The other choices (A, B, C) are incorrect because spironolactone does not primarily act on the proximal convoluted tubule, ascending thick limb of the loop of Henle, or distal convoluted tubule.
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When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse will discuss which food?
- A. Oatmeal
- B. Grapefruit juice
- C. Licorice
- D. Dairy products
Correct Answer: B
Rationale: The correct answer is B, Grapefruit juice. Grapefruit juice can interact with antilipemic drugs by inhibiting the enzyme CYP3A4, leading to increased drug levels in the body and potential toxicity. Oatmeal (A) is a healthy food choice and does not significantly interact with antilipemic drugs. Licorice (C) can interact with medications such as corticosteroids but not specifically antilipemic drugs. Dairy products (D) can interfere with the absorption of some medications but do not have a significant interaction with antilipemic drugs.
Which of the following drugs is used for dermatomycosis treatment:
- A. Nystatin
- B. Griseofulvin
- C. Amphotericin B
- D. Vancomycin
Correct Answer: B
Rationale: The correct answer is B: Griseofulvin. Griseofulvin is used for dermatomycosis treatment because it is an antifungal medication specifically effective against dermatophytes. It works by disrupting the formation of fungal cell walls, leading to their destruction. Nystatin (A) is primarily used for yeast infections, not dermatomycosis. Amphotericin B (C) is a broad-spectrum antifungal, but it is not commonly used for dermatomycosis due to its potential side effects. Vancomycin (D) is an antibiotic effective against bacteria, not fungi. Therefore, the most appropriate choice for dermatomycosis treatment is Griseofulvin.
Lamotrigine can be used in the treatment of:
- A. Partial seizures
- B. Absence
- C. Myoclonic seizures
- D. All of the above
Correct Answer: D
Rationale: Lamotrigine is an antiepileptic drug that is effective in treating partial seizures, absence seizures, and myoclonic seizures. Therefore, the correct answer is D, "All of the above." It works by stabilizing neural membranes and inhibiting glutamate release. It is commonly used as a first-line treatment for various types of seizures. Choices A, B, and C are incorrect because lamotrigine can indeed be used to treat all these seizure types based on its mechanism of action and clinical effectiveness.
All are true EXCEPT: Amiodarone:
- A. Is highly lipid soluble
- B. Has an apparent volume of distribution of approximately 5000 L
- C. Is predominantly eliminated by the kidney
- D. Accumulates in the heart
Correct Answer: C
Rationale: Amiodarone is lipid-soluble (A), has a large Vd (B), and accumulates in tissues like the heart (D); it is metabolized by the liver (C) with a long half-life (E, typically 20-60 days, but 3 weeks is close).
Which of the following cholinesterase inhibitors is irreversible?
- A. Physostigmine
- B. Edrophonium
- C. Neostigmine
- D. Isoflurophate
Correct Answer: D
Rationale: The correct answer is D: Isoflurophate. It is irreversible due to its covalent binding to the cholinesterase enzyme, leading to prolonged inhibition. Physostigmine, Edrophonium, and Neostigmine are reversible cholinesterase inhibitors that bind non-covalently and have shorter durations of action.