Nokea
The average starting dose of warfarin is 5 mg daily. Higher doses of 7.5 mg daily should be considered in which patients?
- A. Pregnant women
- B. Elderly men
- C. Overweight or obese patients
- D. Patients with multiple comorbidities
Correct Answer: C
Rationale: Overweight/obese patients may need higher warfarin doses due to larger volume of distribution; pregnancy contraindicates warfarin.
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Art is a 55-year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be:
- A. This is a parasympathetic response to the vasodilating effects of the drug.
- B. Headaches are common side effects with these drugs. How severe are they?
- C. This is associated with your smoking. Let's work on having you stop smoking.
- D. This is not related to your medication. Are you under a lot of stress?
Correct Answer: B
Rationale: Headaches are a common nitrate side effect due to vasodilation.
What is the advantage of sublingual route of administration of drugs
- A. Prevents first pass effect
- B. Easy to administer
- C. Lipid soluble
- D. Can be spitted out with signs of toxicity
Correct Answer: A
Rationale: Sublingual administration bypasses hepatic first-pass metabolism.
Which of the following drugs used for gout decreases net renal tubular reabsorption of uric acid?
- A. Hypoxanthine
- B. Indomethacin
- C. Colchicine
- D. Allopurinol
Correct Answer: C
Rationale: Colchicine reduces inflammation but also decreases uric acid reabsorption indirectly.
You are to infuse 1,200 mL of IV fluid over 6 hours using a drop factor of 10 gtt/mL. What is the flow rate in drops per minute?
- A. 30 gtt/min
- B. 33 gtt/min
- C. 40 gtt/min
- D. 50 gtt/min
Correct Answer: B
Rationale: Flow rate = (1,200 mL 10 gtt/mL) ÷ (6 60) = 12,000 ÷ 360 = 33.33 gtt/min, rounded to 33 gtt/min.
One major drug used to treat bipolar disease is lithium. Because lithium has a narrow therapeutic range, it is important to recognize symptoms of toxicity, such as:
- A. Orthostatic hypotension
- B. Agitation and irritability
- C. Drowsiness and nausea
- D. Painful urination and abdominal distention
Correct Answer: C
Rationale: Lithium toxicity commonly presents with drowsiness and nausea.