Nokea
Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to:
- A. Increase DNA and RNA synthesis.
- B. Promote the biosynthesis of nucleic acids.
- C. Increase estrogen concentration and estrogen response.
- D. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.
Correct Answer: D
Rationale: Tamoxifen is an antineoplastic medication that competes with estradiol for binding to estrogen in tissues containing high concentrations of receptors. Tamoxifen is used to treat metastatic breast carcinoma in women and men. Tamoxifen is also effective in delaying the recurrence of cancer following mastectomy. Tamoxifen reduces DNA synthesis and estrogen response.
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Clinical dosing of Bethanechol:
- A. Begins at the highest effective dose to obtain a rapid response
- B. Starts at 5 mg to 10 mg PO and is repeated every hour until a satisfactory clinical response is achieved
- C. Requires dosing only once daily
- D. Is the same for both the oral and parenteral route
Correct Answer: B
Rationale: Bethanechol is titrated hourly from 5-10 mg to achieve the desired effect.
The patient tells the nurse about a new drug being tested to treat the disease she was diagnosed with and asks the nurse whether the doctor can prescribe a medication still in the preclinical phase of testing. What is the nurse's best response?
- A. The doctor would have to complete a great deal of paperwork to get approval to prescribe that drug.
- B. Sometimes pharmaceutical companies are looking for volunteers to test a new drug and the doctor could give them your name.
- C. Drugs in the preclinical phase of testing are only tested on animals and so would not be available to you.
- D. Drugs in the preclinical phase of testing are given only to healthy young men and so would not be available to you.
Correct Answer: C
Rationale: During the preclinical phase of testing drugs are tested on animals and are not available to patients. In phase I, the drug is tested on volunteers who are usually healthy young men. It is only in phase III studies that the drug is made available to prescribers who agree to closely monitor patients getting the medication.
Slow channel syndrome is due to
- A. Accumulation of Na+ ions in channels
- B. Accumulation of K+ ions in channels
- C. Accumulation of Mg++ ions in channels
- D. Accumulation of Ca++ ions in channels
Correct Answer: D
Rationale: Slow channel syndrome relates to calcium channel dysfunction.
Selma, who is overweight, recently started taking topiramate for seizures and at her follow-up visit you note she has lost 3 kg. The appropriate action would be:
- A. Tell her to increase her caloric intake to counter the effects of the topiramate.
- B. Consult with a neurologist, as this is not a common adverse effect of topiramate.
- C. Decrease her dose of topiramate.
- D. Reassure her that this is a normal side effect of topiramate and continue to monitor her weight.
Correct Answer: D
Rationale: Weight loss is a common, beneficial side effect of topiramate.
Which is the most authoritative reference for medications that are injected?
- A. Martindale: The Complete
- B. Handbook on Injectable Drugs
- C. DailyMed
- D. Handbook of Nonprescription Drugs
Correct Answer: B
Rationale: The Handbook on Injectable Drugs is the most comprehensive reference available on the topic of compatibility of injectable drugs.