Nokea
The following drugs can be used for treatment of diabetes except one:
- A. Insulines
- B. Biguanides
- C. alfa glucosidase inhibitors
- D. Glucagon
Correct Answer: D
Rationale: Glucagon increases blood glucose levels by promoting glycogenolysis and gluconeogenesis, making it unsuitable for diabetes treatment, unlike the others which lower glucose.
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The nurse is teaching a patient who has completed detoxification for alcohol abuse who will be discharged home with a prescription for disulfiram (Antabuse). Which statement by the patient indicates understanding of the teaching?
- A. Even topical products containing alcohol can have serious adverse effects while I am taking this drug
- B. If I experience drowsiness or skin rash, I should discontinue this drug immediately
- C. It is safe to take a product containing alcohol one week after the last dose of disulfiram
- D. This drug acts by blocking the pleasurable effects of alcohol
Correct Answer: A
Rationale: Disulfiram reacts with any alcohol, even topical; effects linger 2 weeks , and it causes aversion, not blocking pleasure . Disulfiram causes an unpleasant and potentially fatal reaction if alcohol is consumed while taking it and can even occur with topical products containing alcohol.
Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages for her should be:
- A. Started at about half the usual dosage
- B. Not increased over the usual dosage for an adult
- C. Given once daily because of memory issues in the older adult
- D. Withheld if she experiences gastroesophageal reflux
Correct Answer: A
Rationale: Elderly patients start at half dose due to reduced metabolism and clearance.
Patients who are on chronic long-term corticosteroid therapy need education regarding:
- A. Receiving all vaccinations, especially the live flu vaccine
- B. Reporting black tarry stools or abdominal pain
- C. Eating a high carbohydrate diet with plenty of fluids
- D. Small amounts of alcohol are generally tolerated
Correct Answer: B
Rationale: Black tarry stools signal GI bleeding from corticosteroids; live vaccines are contraindicated.
A patient who has chronic liver disease reports contact with a person who has tuberculosis (TB). The nurse will counsel this patient to contact the provider to discuss
- A. a chest x-ray
- B. a TB skin test
- C. liver function tests (LFTs)
- D. prophylactic antitubercular drugs
Correct Answer: B
Rationale: TB exposure requires a skin test first; chest x-ray follows if positive, and LFTs or prophylaxis aren't initial steps. Patients who have exposure to TB should have a TB skin test.
The 'donut hole' in Medicare Part D:
- A. Will be totally eliminated with the federal health-care reform enacted in 2010
- B. Refers to the period of time when annual individual drug costs are between 250 and 2,250 per year and drug costs are covered 75%
- C. Refers to the period between when the annual individual drug costs are 2,970 and 4,750 and the patient pays 52.5% of the costs of brand name drugs (2013)
- D. Has no effect on whether patients continue to fill their prescriptions during the coverage gap
Correct Answer: C
Rationale: The donut hole (2013) is the coverage gap where patients pay more out-of-pocket.