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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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.
A nurse is assessing the patients home medication use. After listening to the patient list current medications, the nurse asks what priority question?
- A. Do you take any generic medications?
- B. Are any of these medications orphan drugs?
- C. Are these medications safe to take during pregnancy?
- D. Do you take any over-the-counter medications?
Correct Answer: D
Rationale: It is important for the nurse to specifically question use of over-the-counter medications because patients may not consider them important. The patient is unlikely to know the meaning of orphan drugs unless they too are health care providers. Safety during pregnancy, use of a generic medication, or classification of orphan drugs are things the patient would be unable to answer but could be found in reference books if the nurse wishes to research them.
A nurse is taking a medication history from a client who has Angina and is to begin taking Ranolazine. The nurse should report which of the following medications in the client's history that can interact with Ranolazine?(Select one that does not apply.)
- A. Digoxin
- B. Simvastatin
- C. Verapamil
- D. Amlodipine
Correct Answer: D
Rationale: Ranolazine interacts with digoxin , simvastatin , and verapamil , increasing levels or effects.
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.
Which of the following statements is correct regarding insulin glargine?
- A. It is primarily used to control postprandial hyperglycemia
- B. It is a 'peakless' insulin
- C. The prolonged duration of activity is due to slow dissociation from albumin
- D. It should not be used in a regimen with insulin lispro or glulisine
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin providing steady glucose control.