What needs to happen to the protein-drug complex for the drugs to reach the cells where the drug can act?
- A. The protein-drug complex must break itself into smaller pieces to enter the capillaries.
- B. The binding site on the protein picks up a chemical to make it soluble in the serum.
- C. The drug must break away from the protein-binding site and float freely.
- D. The drug must be dissolved in the plasma so it can enter the capillaries and then the tissues.
Correct Answer: C
Rationale: Most drugs are bound, to some extent, to proteins in the blood to be carried into circulation. The protein-drug complex is relatively large and cannot enter into capillaries and then into tissues to react. The drug must be freed from the protein's binding site at the tissues. This occurs without the introduction of another chemical or by dissolving in it plasma.
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The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce which instructions to the client?(Select one that does not apply.).
- A. Diarrhea can occur secondary to the metformin.
- B. The repaglinide is not taken if a meal is skipped.
- C. The repaglinide is taken 30 minutes before eating.
- D. Candy or another simple sugar is carried and used to treat mild hyperglycemia episodes.
Correct Answer: D
Rationale: Repaglinide is a rapid-acting oral hypoglycemic agent that stimulates pancreatic insulin secretion that should be taken before meals, and that should be withheld if the client does not eat. Hypoglycemia is a side effect of repaglinide and the client should always be prepared by carrying a simple sugar with her or him at all times. Metformin is an oral hypoglycemic given in combination with repaglinide and works by decreasing hepatic glucose production. A common side effect of metformin is diarrhea. Correct answers include: 1, 2, 3, 4.
Which of the following is natural mineralcorticoid:
- A. Methylprednisolone
- B. Betamethasone
- C. Triamcinolone
- D. Aldosterone
Correct Answer: D
Rationale: Aldosterone is the primary natural mineralocorticoid, regulating sodium and potassium balance.
Methanol causes blindness due to its
- A. Hypersensitivity reactions
- B. Conjugated products
- C. Idiosyncratic reaction
- D. Oxidative products
Correct Answer: D
Rationale: Methanol's metabolite, formic acid (oxidative product), damages the optic nerve, causing blindness.
A nurse has received an order to administer two drugs at the same time of the day. The nurse should first:
- A. Wash her hands before handling the medications
- B. Consult a drug guide for compatibility
- C. Question the patient concerning drug allergies
- D. Identify the patient by checking the armband and asking the patient to state his or her name
Correct Answer: B
Rationale: Consulting a drug guide for compatibility is critical to avoid adverse interactions when administering two drugs simultaneously. Hand washing, allergy checks, and patient identification are also essential but follow ensuring drug compatibility to prevent harm.
Patients who are prescribed olanzapine (Zyprexa) should be monitored for:
- A. Insomnia
- B. Weight gain
- C. Hypertension
- D. Galactorrhea
Correct Answer: B
Rationale: Olanzapine commonly causes significant weight gain.
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