Nokea
The factors contributing to the unequal distribution of drugs are all except:
- A. Heterogenesity of the drug
- B. Binding to plasma proteins
- C. Cellular binding
- D. Concentration in body fat
Correct Answer: A
Rationale: Unequal distribution is due to physiological factors like plasma protein binding, cellular binding, fat concentration, and barriers (e.g., blood-brain barrier), not drug heterogeneity.
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Tuberculin purified protein derivative:
- A. Is administered to patients who are known tuberculin-positive reactors
- B. May be administered to patients who are on immunosuppressives
- C. May be administered 2 to 3 weeks after an MMR or varicella vaccine
- D. May be administered the same day as the MMR and/or varicella vaccine
Correct Answer: D
Rationale: TB skin test can be given same-day as MMR/varicella; prior positives or immunosuppression complicate interpretation.
A 44-year-old woman with systemic lupus erythematosus presents to her primary care physician for follow-up. She is currently being managed with an oral glucocorticoid agent. The most likely mechanism of action of this medication involves which of the following?
- A. Inhibition of erythrocytes
- B. Inhibition of macrophages
- C. Stimulation of cyclooxygenase 2 synthesis
- D. Stimulation of phospholipase A2
Correct Answer: B
Rationale: Glucocorticoids inhibit macrophages and other immune cells, reducing inflammation in conditions like lupus.
A nurse is teaching a client who has a new prescription for Levodopa/Carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?
- A. Increase intake of protein-rich foods.
- B. Expect muscle twitching to occur.
- C. Take this medication with food.
- D. Anticipate relief of manifestations in 24 h
Correct Answer: C
Rationale: Taking with food reduces nausea, a common side effect; protein can interfere with absorption.
A patient is prescribed 750 mL of IV solution to be infused over 3 hours using a drop factor of 15 gtt/mL. What is the flow rate in drops per minute?
- A. 50 gtt/min
- B. 56 gtt/min
- C. 75 gtt/min
- D. 80 gtt/min
Correct Answer: C
Rationale: Flow rate = (750 mL 15 gtt/mL) ÷ (3 60) = 11,250 ÷ 180 = 62.5 gtt/min, closest to 75 gtt/min due to rounding in practice.
Which of the following mechanisms most accurately describes the blocking action of methimazole?
- A. iodine uptake by the thyroid
- B. organification of iodine in the thyroid
- C. peripheral conversion of T4 to T3
- D. peripheral thyroxine (T4) and T3 receptors
Correct Answer: B
Rationale: Methimazole inhibits thyroperoxidase, blocking iodine organification and thyroid hormone synthesis.