Nokea
Therapeutic drug monitoring would be appropriate for which drug?
- A. Acetaminophen
- B. Phenytoin
- C. Albuterol
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because phenytoin has a narrow therapeutic index, requiring monitoring of peak and trough levels to ensure efficacy and avoid toxicity, unlike broader-range drugs. Choice A is incorrect as acetaminophen's wide safety margin and short-term use don't typically need monitoring. Choice C is wrong because albuterol's inhaled route and rapid action don't require blood level checks. Choice D is incorrect since only phenytoin fits the monitoring profile.
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Differences between brand-name drugs and their generic equivalents include:
- A. Active ingredient
- B. Cost
- C. Color of the tablet
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because generics have the same active ingredient as brand-name drugs but typically cost less, per FDA bioequivalence rules. Choice A is incorrect as active ingredients are identical. Choice C is wrong because color may differ but isn't a functional difference. Choice D is incorrect since only cost is a consistent distinction.
Phase IV clinical trials in the United States are also known as:
- A. Human bioavailability trials
- B. Post marketing research
- C. Human safety and efficacy studies
- D. The last stage of animal trials before the human trials begin
Correct Answer: B
Rationale: Choice B is correct because phase IV trials occur after drug approval, monitoring long-term effects and safety in the general population, known as post-marketing research. Choice A is incorrect as bioavailability is studied earlier, like phase I. Choice C is wrong because safety and efficacy are pre-approval (phases I-III). Choice D is incorrect since phase IV isn't animal-based—it's post-approval human study.
Signs of tolerance include:
- A. Needing higher doses for the same effect
- B. Reduced side effects over time
- C. Increased sensitivity to the drug
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because tolerance is defined by needing more drug for the same effect due to body adaptation, per pharmacokinetic principles. Choice B is incorrect as reduced side effects may occur but aren't the definition. Choice C is wrong because sensitivity decreases, not increases. Choice D is incorrect since only A fits.
What predisposing factor most likely contributed to the proximal end of the femur fracture in a 62-year-old woman who lives alone and tripped on a rug in her home?
- A. Failing eyesight leading to an unsafe environment
- B. Renal osteodystrophy from chronic kidney disease (CKD)
- C. Osteoporosis from declining hormone levels
- D. Cerebral vessel changes causing transient ischemic attacks
Correct Answer: C
Rationale: The most likely predisposing factor contributing to the proximal end of the femur fracture in a 62-year-old woman is osteoporosis resulting from declining hormone levels. Osteoporosis weakens the bones, making them more susceptible to fractures, especially in older adults, particularly women. In this case, the fracture can be attributed to the bone density loss associated with osteoporosis, which is a common concern in postmenopausal women. Choices A, B, and D are less likely to have directly contributed to the femur fracture in this scenario. Failing eyesight may increase the risk of falls but does not directly weaken the bones. Renal osteodystrophy affects bone health but is less common in this age group. Cerebral vessel changes causing transient ischemic attacks are related to vascular issues, not bone strength.
A nurse is assessing a client who has been taking lithium carbonate. Which of the following findings should the nurse report to the provider?
- A. Increased urination
- B. Tremors
- C. Weight gain
- D. Blurred vision
Correct Answer: B
Rationale: The correct answer is B: Tremors. Tremors are a sign of lithium toxicity and should be reported immediately. Increased urination is a common side effect of lithium but not an urgent concern requiring immediate reporting. Weight gain is also a common side effect of lithium but does not indicate toxicity. Blurred vision is not typically associated with lithium toxicity; therefore, it is not the priority finding to report.