Nokea
What does the provider understand about the issue of 'Diabetic Renal Protection' with angiotensin-converting enzyme (ACE) medications? Diabetes mellitus patients:
- A. Have a reduced rate of renal progression, but still need to be discontinued when advanced renal issues present
- B. Who start these medications never progress to renal nephropathy
- C. With early renal dysfunction will see it reverse when on ACE medications
- D. Without renal issues are the only ones who benefit from ACE protection
Correct Answer: A
Rationale: ACE inhibitors slow renal progression in diabetes but are stopped in advanced renal failure.
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While caring for a patient with a history of hypothyroidism, the nurse expects which of the following medications to be included in the patient's medication list?
- A. Levothyroxine sodium (Synthroid)
- B. Estrogen (Estradiol)
- C. Iodine 131
- D. Carbimazole (Methimazole)
Correct Answer: A
Rationale: Levothyroxine (Synthroid) is the standard treatment for hypothyroidism, replacing thyroid hormone; carbimazole treats hyperthyroidism, and iodine 131 is for ablation.
The patient is taking a 2-mg dose of ropinerol XR. The drug has a half-life of 12 hours. How long will it be before only 0.25 mg of this drug remains in the patient's system?
- A. 24 hours
- B. 36 hours
- C. 48 hours
- D. 60 hours
Correct Answer: B
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to half of the peak level it previously achieved. At 12 hours there will be 1 mg of the drug available to the body. At 24 hours there will be 0.5 mg, at 36 hours there will be 0.25 mg, at 48 hours there will be 0.125 mg, and at 60 hours there will be 0.0625 mg.
Which of the following medications is classified as a Class IA antiarrhythmic?
- A. Amiodarone
- B. Quinidine
- C. Sotalol
- D. Diltiazem
Correct Answer: B
Rationale: Quinidine is a Class IA antiarrhythmic, blocking sodium channels and prolonging the action potential.
Which of the following are poorly perfused tissues?
- A. Heart
- B. Brain
- C. Liver
- D. Kidneys
Correct Answer: B
Rationale: This appears to be a trick question; heart, brain, liver, and kidneys are well-perfused. Assuming intent was poorly perfused, none fit, but B (Brain) is least correct here as it's well-perfused.
The nurse is discussing smoking cessation with a nurse colleague who smokes. Which statement indicates a readiness to quit smoking?
- A. I don't smoke around my children or inside the house
- B. I want to stop smoking, but I will need help to do it
- C. I will quit so my co-workers will stop harassing me about it
- D. If I cut down gradually, I should be able to quit
Correct Answer: B
Rationale: Readiness shows intent and help-seeking; external pressure or gradual cutdown don't confirm it. Patients exhibit readiness when they state a desire to quit along with a request for professional assistance.