Nokea
The primary use of aminoglycosides is to treat:
- A. Gram-positive infections
- B. Gram-negative infections
- C. Fungal infections
- D. Viral infections
Correct Answer: B
Rationale: Aminoglycosides like gentamicin are primarily effective against Gram-negative bacteria due to their mechanism targeting bacterial ribosomes.
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The nurse is preparing to administer an intradermal injection. The nurse would insert the needle at which angle?
- A. 15 degrees
- B. 30 degrees
- C. 45 degrees
- D. 90 degrees
Correct Answer: A
Rationale: When giving an intradermal injection, the needle is inserted bevel up at a 15-degree angle. The nurse would insert the needle at a 90-degree angle for an intramuscular injection or for a patient who is obese and requires a subcutaneous injection. Typically a subcutaneous injection is given at a 45-degree angle.
A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this is due to:
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. Once in the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.
A client asks the NP about the differences in drug effects between men and women. What is known about the differences between the pharmacokinetics of men and women?
- A. Body temperature varies between men and women.
- B. Muscle mass is greater in women.
- C. Percentage of fat differs between genders.
- D. Proven subjective factors exist between the genders.
Correct Answer: C
Rationale: Gender differences in pharmacokinetics are largely due to fat percentage , affecting drug distribution; muscle mass is greater in men (B is false), and temperature/subjective factors are less impactful.
A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
- A. Calcium chloride
- B. Calcium gluconate
- C. Calcitonin (Miacalcin)
- D. Large doses of vitamin D
Correct Answer: C
Rationale: The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the serum calcium concentration.
Aminoglycosides are most effective against which kind of microorganism?
- A. Aerobic gram-negative bacteria
- B. Anaerobic gram-negative bacteria
- C. Aerobic gram-positive bacteria
- D. Anaerobic gram-positive bacteria
Correct Answer: A
Rationale: Aminoglycosides target aerobic gram-negative bacteria by inhibiting protein synthesis, requiring oxygen-dependent uptake.