Nokea
The nurse is assessing a diabetic patient who has presented at the clinic reporting several hypoglycemic episodes during the past 3 weeks. The nurse questions the patient about the use of herbal or alternative therapies, suspecting what herbal remedy could cause the hypoglycemic episodes?
- A. St. John's wort
- B. Kava
- C. Fish oil
- D. Ginseng
Correct Answer: D
Rationale: Ginseng is known to decrease blood sugar levels. If the patient used this in combination with his or her oral antidiabetic agent, diet, and exercise, his or her blood sugar could drop below therapeutic levels. St. John's wort interacts with many drugs, but not with antidiabetic agents. Kava is associated with liver toxicity. Fish oil has been associated with decreased coronary artery disease.
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The mean weight of 500 college students is 70 kg and the standard deviation is 3 kg. Assuming that the weight is normally distributed, determine how many students weigh less than 64 kg.
- A. 5
- B. 11
- C. 15
- D. 20
Correct Answer: B
Rationale: Z-score: (64-70)/3 = -2. P(Z < -2) = 1 - P(Z ≤ 2). Using standard tables, P(Z ≤ 2) ≈ 0.9772, so P(Z < -2) = 1 - 0.9772 = 0.0228 (document says 0.02128, likely a typo). Then, 0.0228 * 500 ≈ 11, matching the document.
The following can be used for diabetes mellitus:
- A. Desmoporesine
- B. Insuline preparations
- C. Chlorpropamide
- D. Metformin
Correct Answer: A
Rationale: Insulin, chlorpropamide, metformin, and acarbose (B, C, D, E) are all used for diabetes management.
A patient presents to the emergency department with a drug level of 50 units/mL. The half-life of this drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and no more drug is given. How long will it take for the blood level to reach the non-toxic range?
- A. 30 minutes
- B. 1 hour
- C. 2 hours
- D. 3 hours
Correct Answer: B
Rationale: Half-life is the time required for the serum concentration of a drug to decrease by 50%. After 1 hour, the serum concentration would be 25 units/mL (50/2) if the body can properly metabolize and excrete the drug. After 2 hours, the serum concentration would be 12.5 units/mL (25/2) and reach the nontoxic range. In 30 minutes the drug level would be 37.5 units/mL, whereas in 3 hours the drug level would be 6.25.
A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy Category B drug. What would the nurse inform the patient?
- A. Adequate studies in pregnant women have demonstrated there is no risk to the fetus.
- B. Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women.
- C. Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant women.
- D. There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks.
Correct Answer: B
Rationale: Category B indicates that animal studies have not demonstrated a risk to the fetus. However, there have not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of pregnancy and no evidence of risk in later trimesters. Category A indicates that adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters. Category C indicates that animal studies have shown an adverse effect on the fetus, but no adequate studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the use of the drugs in pregnant women may outweigh potential risks.
Monitoring a patient on a high-dose aspirin level includes:
- A. Salicylate level
- B. Complete blood count
- C. Urine pH
- D. All of the above
Correct Answer: D
Rationale: High-dose aspirin requires salicylate levels , CBC for bleeding, and urine pH for excretion monitoring.