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The nurse is explaining how medications work to a group of peers and explains that disruption of a single step in any enzyme system disrupts what?
- A. Cell life
- B. Cell membrane
- C. Cell receptor sites
- D. Cell function
Correct Answer: D
Rationale: If a single step in one of the many enzyme systems is blocked, normal cell function is disrupted. Cell life and cell membrane may be impacted by disruption of some enzymes but not all enzymes. Receptor sites would not be disrupted by disruption in a single step in the enzyme system.
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A nurse is teaching a patient about a new prescription for hydrochlorothiazide. Which statement indicates that the patient understands the teaching?
- A. I should increase my potassium intake.
- B. I may experience swelling in my legs.
- C. I need to monitor my blood sugar levels.
- D. I can take this medication any time of the day.
Correct Answer: A
Rationale: Hydrochlorothiazide can cause hypokalemia; increasing potassium intake shows understanding, unlike swelling (opposite effect) or timing flexibility (best in morning).
Which of the following legislative acts allowed the Food and Drug Administration (FDA) to tighten control over the quality of drugs and required that safety and efficacy standards be established?
- A. Pure Food and Drug Act of 1906
- B. Federal Food, Drug, and Cosmetic Act of 1938
- C. Durham Humphrey Amendment of 1951
- D. Kefauver-Harris Act of 1962
Correct Answer: D
Rationale: The Kefauver-Harris Act was the result of the use of the 1960s drug thalidomide (Thalomid). The public concern led to the legislation that gave the FDA regulatory control over testing and evaluating of drugs and allowed it to set standards for efficacy and safety. The Pure Food and Drug Act required labeling to eliminate false claims. The Federal Food, Drug, and Cosmetic Act gave the FDA the power to enforce standards for testing drug toxicity and monitoring labeling. The Durham-Humphrey Amendment enforced prescriptions for distribution.
Choose a drug that is contraindicated in pregnancy because it can damage fetal kidneys:
- A. Hydralazine
- B. Nifedipine
- C. Captopril
- D. Propranolol
Correct Answer: C
Rationale: ACE inhibitors like captopril cause fetal renal damage.
Angiotensin-converting enzyme inhibitors are the drug of choice in treating hypertension in diabetic patients because they:
- A. Improve insulin sensitivity
- B. Improve renal hemodynamics
- C. Reduce the production of angiotensin II
- D. All of the above
Correct Answer: D
Rationale: ACE inhibitors benefit diabetics by enhancing insulin sensitivity, protecting kidneys, and blocking angiotensin II.
The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
- A. Glucose level
- B. Calcium level
- C. Potassium level
- D. Prothrombin time
Correct Answer: B
Rationale: Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of therapy, a complete blood count, platelet count, and serum calcium levels should be assessed. These blood levels, along with cholesterol and triglyceride levels, should be monitored periodically during therapy. The nurse should assess for hypercalcemia while the client is taking this medication. Signs of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and flank pain.