Nokea
Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages for her should be:
- A. Started at about half the usual dosage
- B. Not increased over the usual dosage for an adult
- C. Given once daily because of memory issues in the older adult
- D. Withheld if she experiences gastroesophageal reflux
Correct Answer: A
Rationale: Elderly patients start at half dose due to reduced metabolism and clearance.
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A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is:
- A. 2 to 4 hours after administration
- B. 4 to 12 hours after administration
- C. 16 to 18 hours after administration
- D. 18 to 24 hours after administration
Correct Answer: B
Rationale: Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5 hours, it peaks in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions most likely occur during peak time.
Which statement accurately describes a drug agonist?
- A. A drug that reacts with specific receptor sites on a cell and prevents the reaction of another chemical with a different receptor site on that cell
- B. A drug that interferes with the enzyme systems that act as catalysts for different chemical reactions
- C. A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site
- D. A drug that reacts with receptor sites to block normal stimulation, producing no effect
Correct Answer: C
Rationale: Agonists are drugs that produce effects similar to those produced by naturally occurring neurotransmitters, hormones, or other substances found in the body. Noncompetitive antagonists are drugs that react with certain receptor sites, preventing the reaction of another chemical with a different receptor site. Drug-enzyme interactions interfere with the enzyme systems that stimulate various chemical reactions.
A patient receiving gentamicin should be monitored for which potential adverse effect?
- A. Nephrotoxicity
- B. Hepatotoxicity
- C. Ototoxicity
- D. Both A and C
Correct Answer: D
Rationale: Gentamicin, an aminoglycoside, commonly causes nephrotoxicity and ototoxicity , requiring monitoring of renal function and hearing.
Idiosyncrasy is:
- A. A genetically determined abnormal reaction to drugs
- B. A characteristic toxic effect at therapeutic doses
- C. An altered physiological state produced by repeated drug use
- D. An immunologically mediated reaction
Correct Answer: A
Rationale: Idiosyncrasy is a genetically determined unusual response to a drug, e.g., G6PD deficiency with primaquine.
A nurse is providing discharge teaching to a client who has a new prescription for Clozapine. Which of the following statements should the nurse include in the teaching?
- A. You should have a high-carbohydrate snack between meals and at bedtime.
- B. You are likely to develop hand tremors if you take this medication for a long period of time.
- C. You may experience temporary to the first record of the first dose.
- D. You should have your white blood cell count monitored every week.
Correct Answer: D
Rationale: Clozapine requires weekly WBC monitoring due to risk of agranulocytosis.