Nokea
The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day. If this is done:
- A. The initial dose of glargine is reduced by 20% to avoid hypoglycemia
- B. The initial dose of glargine is 2 to 10 units per day
- C. Patients who have been on high doses of NPH will need tests for insulin antibodies
- D. Obese patients may require more than 100 units per day
Correct Answer: A
Rationale: Switching to glargine reduces the dose by 20% to prevent hypoglycemia due to its steady action vs. NPH peaks.
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In response to the patients question about how to know whether drugs are safe, the nurse explains that all medications undergo rigorous scientific testing controlled by what organization?
- A. Food and Drug Administration (FDA)
- B. Drug Enforcement Agency (DEA)
- C. Centers for Disease Control and Prevention (CDC)
- D. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
Correct Answer: A
Rationale: The FDA is responsible for controlling and regulating the development and sale of drugs in the United States, allowing new drugs to enter the market only after being subjected to rigorous scientific testing. The DEA regulates and controls the use of controlled substances. The CDC monitors and responds to infectious diseases. The JCAHO is an accrediting body that inspects acute care facilities to ensure minimum standards are met.
The patient is taking a drug that affects the body by increasing cellular activity. Where does this drug work on the cell?
- A. Receptor sites
- B. Cell membrane
- C. Golgi body
- D. Endoplasmic reticulum
Correct Answer: A
Rationale: Many drugs are thought to act at specific areas on cell membranes called receptor sites. After the receptor site is activated, this in turn activates the enzyme systems to produce certain effects, such as increased or decreased cellular activity, changes in cell membrane permeability, or alterations in cellular metabolism. Receptor sites are generally located on the outside of cells and allow the drug to bypass the cell membrane. The Golgi body and endoplasmic reticulum are not involved in this process.
A nurse is completing a nursing history for a client who takes Simvastatin. The nurse should identify which of the following disorders as a contraindication to adding Ezetimibe to the client's medications?
- A. History of severe constipation
- B. History of hypertension
- C. Active hepatitis C
- D. Type 2 diabetes mellitus
Correct Answer: C
Rationale: Active hepatitis C contraindicates ezetimibe due to increased liver risk with statins.
A nurse is caring for a child on the pediatric unit. A drug is ordered for the child, but there is no pediatric dose listed for the drug. To make sure that the right dose has been ordered, what will the nurse use to calculate the correct dose?
- A. Surface area
- B. Height
- C. Birth date
- D. Age at gestation
Correct Answer: A
Rationale: Surface area, calculated via nomograms using height and weight, is the most accurate method for pediatric dosing adjustments.
Drugs mostly cross biological membranes by
- A. Passive diffusion
- B. Active diffusion
- C. Active transport
- D. Carrier mediated transport
Correct Answer: A
Rationale: Most drugs cross membranes via passive diffusion based on concentration gradients.