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symptomatic and metabolic improvement. Until that time, which of the following might be administered adjunctively to suppress glucocorticoid synthesis?
- A. Cimetidine
- B. Cortisol (massive doses)
- C. Fludrocortisone
- D. Ketoconazole
Correct Answer: D
Rationale: Ketoconazole inhibits glucocorticoid synthesis by blocking adrenal steroidogenesis, useful in Cushing's syndrome management.
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A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?
- A. One
- B. Two
- C. Three
- D. Four
Correct Answer: A
Rationale: A long half-life of 4 days means the drug remains effective for an extended period, typically requiring once-daily dosing.
A nurse is ordered to infuse 1,500 mL of IV fluid over 12 hours using a drop factor of 15 gtt/mL. What is the flow rate in drops per minute?
- A. 31.25 gtt/min
- B. 33.33 gtt/min
- C. 41.67 gtt/min
- D. 62.5 gtt/min
Correct Answer: A
Rationale: Flow rate = (1,500 mL 15 gtt/mL) ÷ (12 60) = 22,500 ÷ 720 = 31.25 gtt/min, exactly matching option A.
A nurse is assessing a client and notes that the client has developed swelling of the eyelids and lips after administration of a prescribed medication. The nurse interprets this finding as specifically indicating which of the following?
- A. Mild allergic reaction
- B. Anaphylactic shock
- C. Angioedema
- D. Drug idiosyncrasy
Correct Answer: C
Rationale: Angioedema is a type of allergic drug reaction manifested by the collection of fluid in the subcutaneous tissues, most commonly affecting the eyelids, lips, mouth, and throat. Allergic reactions can be manifested by a wide range of signs and symptoms such as itching, rashes, and hives. Anaphylactic shock is a serious allergic reaction that requires immediate medical attention. Drug idiosyncrasy describes any unusual or abnormal reaction to a drug, one that is different from the one normally expected.
While administering a medication that the nurse has researched and found to have limited effectiveness, the patient tells the nurse, I have read all about this drug and it is such a wonder drug. I'm so lucky my doctor prescribed it because I just know it will treat my problem. The nurse suspects this drug will be more effective than usual for this patient because of what effect?
- A. Cumulative effect
- B. First-pass effect
- C. Placebo effect
- D. Cross-tolerance effect
Correct Answer: C
Rationale: A drug is more likely to be effective if the patient thinks it will work than if the patient believes it will not work. This is called the placebo effect. If a drug is taken in successive doses at intervals that are shorter than recommended, or if the body is unable to eliminate a drug properly, the drug can accumulate in the body, leading to toxic levels and adverse effects. This is a cumulative effect. First-pass effect addresses the reduction of available drug when taken orally due to metabolism in the liver before the drug reaches the bloodstream. Cross-tolerance is resistance to drugs within the same class.
Beta-blockers decrease triglyceride levels and increase levels of HDL cholesterol.
- A. TRUE
- B. FALSE
Correct Answer: B
Rationale: Beta-blockers typically increase triglycerides and decrease HDL cholesterol, opposite to the statement.