Nokea
The adverse events of sulfonylurea drugs are:
- A. Hypoglycemia and weight gain
- B. Gastrointestinal symptoms
- C. Aggravation of heart failure
- D. Increased risk of bone fracture in females
Correct Answer: A
Rationale: Sulfonylureas like glyburide cause hypoglycemia and weight gain by increasing insulin release.
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The nurse administers a specific medication to an older adult patient every 4 hours. The patient has a history of chronic renal failure. Why would this patient be at risk for toxic drug levels?
- A. Cumulative effect
- B. First-pass effect
- C. Drug interactions
- D. Cross-tolerance effect
Correct Answer: A
Rationale: 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. Drug interactions occur when taken with other drugs, food, or complementary alternative therapies. Cross-tolerance is resistance to drugs within the same class.
The mean weight of 500 college students is 70 kg and the standard deviation is 3 kg. Assuming that the weight is normally distributed, determine how many students weigh exactly 64 kg.
- B. 5
- C. 10
- D. 15
Correct Answer: A
Rationale: In a continuous normal distribution, the probability of an exact value (e.g., P(X=64)) is 0, as probability is measured over intervals, not points. Thus, 0 students, as per the document.
Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
- A. OTC drugs are safe and do not cause adverse effects if taken properly.
- B. OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).
- C. OTC drugs are different from any drugs available by prescription and cost less.
- D. OTC drugs could cause serious harm if not taken according to directions.
Correct Answer: D
Rationale: It is important to follow package directions because OTCs are medications that can cause serious harm if not taken properly. OTCs are drugs that have been determined to be safe when taken as directed; however, all drugs can produce adverse effects even when taken properly. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC education should always be included as a part of the hospital discharge instructions.
Angina pectoris, tachycardia, and arrhythmias are possible adverse effects of which of the following drugs?
- A. Clonidine
- B. Phenylephrine
- C. Propranolol
- D. Salbutamol
Correct Answer: D
Rationale: Salbutamol, a beta-2 agonist, can cause cardiac stimulation as a side effect.
The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which of the following body areas?
- A. Back
- B. Axilla
- C. Soles of the feet
- D. Palms of the hands
Correct Answer: B
Rationale: Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions in which permeability is poor (back, palms, soles).