Nokea
The ganglion blocking drugs act by
- A. Competing with acetylcholine at neuromuscular junctions
- B. Preventing release of acetylcholine
- C. Preventing nerve conduction in post ganglionic segment
- D. Preventing catecholamine release or inactivating it
Correct Answer: B
Rationale: Ganglion blockers (e.g., hexamethonium) prevent acetylcholine release at ganglia.
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Lactacidosis is most frequent in the cases of:
- A. While treated with acarbose
- B. While treated with glibenclamid
- C. While treated with metformin
- D. Triamcinolone
Correct Answer: C
Rationale: Metformin is the most common cause of lactic acidosis among antidiabetic drugs, particularly in renal failure.
The nurse uses what term to describe the drug level required to have a therapeutic effect?
- A. Critical concentration
- B. Dynamic equilibrium
- C. Selective toxicity
- D. Active transport
Correct Answer: A
Rationale: A critical concentration of a drug must be present before a reaction occurs within the cells to bring about the desired therapeutic effect. A dynamic equilibrium is obtained from absorption of a drug from the site of drug entry, distribution to the active site, metabolism in the liver, and excretion from the body to have a critical concentration. Selective toxicity is the ability of a drug to attach only to those systems found in foreign cells. Active transport is the process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney.
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.
A nurse is providing teaching to a client who is starting Simvastatin. Which of the following information should the nurse include in the teaching?
- A. Take this medication in the evening.
- B. Change position slowly when rising from a chair.
- C. Maintain a steady intake of green leafy vegetables.
- D. Consume no more than 1 L/day of fluid
Correct Answer: A
Rationale: Simvastatin is taken in the evening when cholesterol synthesis peaks.
A doctor orders 250 mL of IV fluid to be infused over 1 hour using microdrip tubing (60 gtt/mL). What is the flow rate in drops per minute?
- A. 100 gtt/min
- B. 120 gtt/min
- C. 150 gtt/min
- D. 250 gtt/min
Correct Answer: D
Rationale: Flow rate = (250 mL 60 gtt/mL) ÷ (1 60) = 15,000 ÷ 60 = 250 gtt/min, matching microdrip where mL/hr = gtt/min.