Nokea
The patient is prescribed a medication that was just placed in Phase IV study. The patient tells the nurse, This medication is too expensive. Could the doctor order a generic form of this medication? What is the nurse's most accurate response?
- A. Medications are not produced in generic form until the patent expires, which normally takes several years.
- B. You can request the generic form but the binder used may make the drug less effective for this medication.
- C. The generic form of the medication would not be any less expensive because this is a relatively new medication.
- D. Generic medications are lower quality drugs and that would mean you would not be getting the best treatment available.
Correct Answer: A
Rationale: When a new drug enters the market, it is given a time-limited patent; generic forms of the medication cannot be produced until the patent expires. Because no generic version of this drug will exist because it is so new, it is impossible to predict what binder will be used or what the cost would be.
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Hypoglycemic mechanism of biguanides is:
- A. Enhance closure of ATP sensitive K+ channels
- B. Inhibits gluconeogenesis in the liver
- C. Enhance glucose absorption from gastro-intestinal tract
- D. Decrease glycolysis in the peripheral tissue
Correct Answer: B
Rationale: Biguanides like metformin inhibit hepatic gluconeogenesis, reducing blood glucose production.
A nurse is caring for a client who is receiving moderate sedation with Diazepam IV. The client is oversedated. Which of the following medications should the nurse anticipate administering to this client?
- A. Ketamine
- B. Naltrexone
- C. Flumazenil
- D. Fluvoxamine
Correct Answer: C
Rationale: Flumazenil reverses benzodiazepine oversedation, like diazepam.
Nicotine replacement therapy (NRT):
- A. Is widely distributed in the body only when the gum products are used
- B. Does not cross the placenta and so is safe for pregnant women
- C. Delays healing of esophagitis and peptic ulcers
- D. Has no drug interactions when a transdermal patch is used
Correct Answer: C
Rationale: NRT delays GI ulcer healing due to nicotine's effects on acid secretion.
A nurse is teaching a client who has a new prescription for Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?
- A. Remove the patch each evening.
- B. Cut each patch in half if angina attacks are under control.
- C. Take off the nitroglycerin patch for 30 min if a headache occurs.
- D. Apply a new patch every 48 hr
Correct Answer: A
Rationale: Removing the patch nightly prevents tolerance to nitroglycerin.
The volume of distribution (Vd) for a drug that is completely retained in the vascular compartment would be?
- A. High
- B. Low
- C. Unchanged
- D. Cannot be determined
Correct Answer: B
Rationale: A drug confined to the vascular compartment (e.g., plasma) has a low Vd, close to plasma volume (about 0.06 L/kg), indicating limited distribution.