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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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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.
A nurse is teaching a client who has a new prescription for Diphenhydramine for allergic Rhinitis. The nurse should instruct the client to monitor for which of the following adverse reactions of this medication? (Select one that does not apply.)
- A. Dry mouth
- B. Nonproductive cough
- C. Urinary Hesitation
- D. Drowsiness
Correct Answer: B
Rationale: Diphenhydramine causes dry mouth , drowsiness , and urinary hesitation due to anticholinergic effects.
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.
A 24 year-old man with a history of substance abuse is suffering from generalized anxiety disorder. Which of the following drugs would be the most suitable for the management of his condition?
- A. Zolpidem
- B. Buspirone
- C. Midazolam
- D. Triazolam
Correct Answer: B
Rationale: Buspirone, a non-benzodiazepine, treats anxiety without dependence risk.
A pharmacology student asks the instructor what an accurate description of a drug agonist is. What is the instructor's best response?
- A. A drug that reacts with a receptor site on a cell preventing a reaction with another chemical on a different receptor site
- B. A drug that interferes with the enzyme systems that act as catalyst for different chemical reactions
- C. A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site
- D. A drug that reacts with receptor sites to block normal stimulation, producing no effect
Correct Answer: C
Rationale: Agonists are drugs that produce effects similar to those produced by naturally occurring neurotransmitters, hormones, or other substances found in the body. Noncompetitive antagonists are drugs that react with some receptor sites preventing the reaction of another chemical with a different receptor site. Drug-enzyme interactions interfere with the enzyme systems that stimulate various chemical reactions.