Nokea
What is the correct statement concerning noncompetitive antagonism:
- A. The potency of the drug does not change
- B. the number of receptors able to bind the agonist is affected
- C. by increasing the conc. of the agonist, we cannot overcome the problem
- D. non of the above is wrong
Correct Answer: D
Rationale: All statements are correct: noncompetitive antagonism reduces efficacy (not potency), affects receptor availability, and cannot be overcome by increasing agonist concentration.
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The telephone triage nurse receives a call from a patient asking for a prescription for a narcotic to manage his surgical pain. The nurse explains that narcotic prescriptions must be written and cannot be called in to the pharmacy. The patient says, Why are narcotics so difficult to get a prescription for? What is the nurse's best response?
- A. The Drug Enforcement Agency (DEA) determines the risk for addiction and the Food and Drug Administration (FDA) enforces their control.
- B. The increase in the number of drug addicts has made the rules stronger.
- C. The Centers for Disease Control and Prevention (CDC) regulates use of controlled substances to reduce the risk of injury.
- D. Controlled substances like narcotics are controlled by the FDA and the DEA.
Correct Answer: D
Rationale: Controlled substances are controlled by the FDA and the DEA: the DEA enforces control while the FDA determines abuse potential. Regulations related to controlled substances have remained strict and specific and have not been significantly impacted by substance abusers. The CDC is not involved in control of narcotics and other controlled substances.
Potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propylthiouracil. Patients should be taught to report:
- A. Tinnitus and decreased salivation
- B. Fever and sore throat
- C. Hypocalcemia and osteoporosis
- D. Laryngeal edema and difficulty swallowing
Correct Answer: B
Rationale: Fever and sore throat signal granulocytopenia with propylthiouracil; other symptoms are unrelated.
A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. (Select one that does not apply.)
- A. Tinnitus
- B. Ototoxicity
- C. Hyperkalemia
- D. Hypomagnesemia
Correct Answer: C
Rationale: Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-nonspecific medications that affect the synthesis of DNA by causing the cross-linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity, tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Amifostine (Ethyol) may be administered before cisplatin to reduce the potential for renal toxicity. Correct answers include: 1 (Tinnitus), 2 (Ototoxicity), 5 (Nephrotoxicity), 6 (Hypomagnesemia).
Zero order kinetics is seen with
- A. Phenytoin
- B. Phenobarbital
- C. Erythromycin
- D. Digoxin
Correct Answer: A
Rationale: Phenytoin exhibits zero-order kinetics at high doses (rate is constant, not proportional).
Digoxin levels need to be monitored closely when the following medication is started:
- A. Loratadine
- B. Diphenhydramine
- C. Ipratropium
- D. Albuterol
Correct Answer: D
Rationale: Albuterol , a beta-agonist, can increase digoxin levels by enhancing its effects, requiring close monitoring; antihistamines and ipratropium have minimal impact.