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The patient is stating that he has a headache and asks the nurse which over-the-counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest?
- A. A capsule
- B. A tablet
- C. A powder
- D. An enteric-coated tablet
Correct Answer: C
Rationale: Of the types of oral medications listed, the powder form would be absorbed the fastest, thus having a faster onset. The tablet, the capsule, and, finally, the enteric-coated tablet would be absorbed next, in that order.
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When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication, that is not highly protein bound?
- A. Renal excretion will be faster.
- B. The drug will be metabolized quickly.
- C. The duration of action of the medication will be shorter.
- D. The duration of action of the medication will be longer.
Correct Answer: D
Rationale: Drugs that are bound to plasma proteins are characterized by longer duration of action. Protein binding does not make renal excretion faster, does not speed up drug metabolism, and does not cause the duration of action to be shorter.
When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. Which of these processes describes selective enzyme interaction?
- A. The drug alters cell membrane permeability.
- B. The drug's effectiveness within the cell walls of the target tissue is enhanced.
- C. The drug is attracted to a receptor on the cell wall, preventing an enzyme from binding to that receptor.
- D. The drug binds to an enzyme molecule and inhibits or enhances the enzyme's action with the normal target cell.
Correct Answer: D
Rationale: With selective enzyme interaction, the drug attracts the enzymes to bind with the drug instead of allowing the enzymes to bind with their normal target cells. As a result, the target cells are protected from the action of the enzymes. This results in a drug effect. The actions described in the other options do not occur with selective enzyme interactions.
When administering drugs, the nurse remembers that the duration of action of a drug is defined as which of these?
- A. The time it takes for a drug to elicit a therapeutic response
- B. The amount of time needed to remove a drug from circulation
- C. The time it takes for a drug to achieve its maximum therapeutic response
- D. The time period at which a drug's concentration is sufficient to cause a therapeutic response
Correct Answer: D
Rationale: Duration of action is the time during which drug's concentration is sufficient to elicit a therapeutic response. The other options do not define duration of action. A drug's onset of action is the time it takes for the drug to elicit a therapeutic response. A drug's peak effect is the time it takes for the drug to reach its maximum therapeutic response. Elimination is the length of time it takes to remove a drug from circulation.
The patient is receiving two different drugs. At current dosages and dosage forms, both drugs have the same concentration of the active ingredient. Which term is used to identify this principle?
- A. Bioequivalent
- B. Synergistic
- C. Proddrugs
- D. Steady state
Correct Answer: A
Rationale: Two drugs absorbed into the circulation in the same amount (in specific dosage forms) have the same bioavailability; thus, they are bioequivalent. A drug's steady state is the physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed from each dose. The term synergistic refers to two drugs, given together, with a resulting effect that is greater than the sum of the effects of each drug given alone. A prodrug is an inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body.
When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient's blood pressure is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse drug reaction?
- A. Adverse effect
- B. Allergic reaction
- C. Idosyncratic reaction
- D. Pharmacologic reaction
Correct Answer: D
Rationale: A pharmacologic reaction is an extension of a drug's normal effects in the body. In this case, the antihypertensive drug lowered the patient's blood pressure levels too much. The other options do not describe a pharmacologic reaction. An adverse effect is a predictable, well-known adverse drug reaction that results in minor or no changes in patient management. An allergic reaction (also known as a hypersensitivity reaction) involves the patient's immune system. An idiosyncratic reaction is unexpected and is defined as a genetically determined abnormal response to normal dosages of a drug.