The tricyclic antidepressants should be prescribed cautiously in patients with:
- A. Eczema
- B. Asthma
- C. Diabetes
- D. Heart disease
Correct Answer: D
Rationale: TCAs can cause cardiac arrhythmias, necessitating caution in heart disease.
You may also like to solve these questions
In which type of cell are ligand-gated ion channels most commonly found?
- A. Cells that are terminally differentiated
- B. Cells that produce large proteins
- C. Cells that need to respond quickly to external stimuli
- D. Cells that respond to mechanic forces
Correct Answer: C
Rationale: Ligand-gated ion channels enable rapid responses to stimuli, common in excitable cells like neurons and muscle cells.
The type of adverse drug reaction that is idiosyncratic when a drug given in the usual therapeutic doses is type:
- A. A
- B. B
- C. C
- D. D
Correct Answer: B
Rationale: Type B reactions are idiosyncratic, unpredictable responses to normal doses, unlike dose-related Type A or chronic Type C/D.
Under the influence of thyroxin, cholesterol level in the blood:
- A. Increase
- B. Decrease
- C. Does not change
Correct Answer: B
Rationale: Thyroxine lowers cholesterol by increasing its metabolism and excretion.
The patient has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a (Rebif). The patient takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per injection. If the patient takes an injection on Monday, how much of the drug would still be in the patient's system when she takes her next injection on Wednesday, assuming the half-life of the drug is 24 hours?
- A. 22 mcg
- B. 16.5 mcg
- C. 11 mcg
- D. 5.5 mcg
Correct Answer: C
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to 1 half the peak level it previously achieved. On Tuesday, there would be 22 mcg remaining in the body, so option A is incorrect. On Wednesday 11 mcg would remain, so option C is the correct answer. At 12 hours before taking the next dose on Wednesday, there would be 16.5 mcg remaining. If the injection were not taken on Wednesday, 12 hours after the dose was due, there would be 5.5 mcg remaining.
While collecting a medication history, the patient admits to doubling the recommended dosage of an over-the-counter (OTC) medication, saying its harmless or they would require a prescription. What is the nurses best response?
- A. OTC drugs are serious medications and carry serious risks if not taken as directed.
- B. Taking medications like that is careless and you could kill yourself doing it.
- C. Sometimes you need to take more than the package directs to treat the symptoms.
- D. Did you notify your doctor of the increased dosage you were taking?
Correct Answer: A
Rationale: OTC drugs are no less a medication than prescription drugs and carry the same types of risks for overdosage and toxicity if directions are not followed. Although increasing the dosage is careless and dangerous, it is important to use the information as a teaching opportunity rather than scolding the patient. Agreeing with the patient or asking her if she talked to the doctor misses the teaching opportunity, which could be harmful for the patient.