Nokea
What percentage of the administered drug will be eliminated by the liver?
- A. 20%
- B. 40%
- C. 50%
- D. 60%
Correct Answer: C
Rationale: The correct answer is C because hepatic clearance accounts for the elimination of drugs by the liver. With a hepatic clearance of 4.86 L/h and a renal clearance of 0.54 L/h, 50% of the drug will be eliminated by the liver.
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Which of the following factors regulates the relationship between drug concentration and drug-receptor complex formation?
- A. The pharmacological response
- B. The volume of distribution of the drug
- C. The total clearance of the drug
- D. The law of mass action
Correct Answer: D
Rationale: The relationship between drug concentration and drug-receptor complex formation is regulated by the law of mass action, which determines the rate of association and dissociation of the drug-receptor complex based on the concentrations of the drug and the receptor.
The nurse educator on the unit receives a list of high- alert drugs. Which strategy is recommended to decrease the risk of errors? (Select all that apply.)
- A. Store drugs on a shelf for quick retrieval.
- B. Limit access to high-alert drugs.
- C. Use special labels for high-alert drugs.
- D. Provide increased training to staff.
Correct Answer: B
Rationale: The correct answer is B: Limit access to high-alert drugs. This strategy is recommended to decrease the risk of errors because it restricts the availability of high-risk medications to only authorized personnel, reducing the likelihood of medication errors. By limiting access, only trained and qualified staff members will handle these drugs, minimizing the potential for mistakes.
Explanation for other choices:
A: Storing drugs on a shelf for quick retrieval may increase the risk of errors as it allows easier access to high-alert drugs, potentially leading to misuse or incorrect administration.
C: Using special labels for high-alert drugs can be helpful but may not be as effective as limiting access in preventing errors.
D: Providing increased training to staff is beneficial, but alone may not be sufficient to reduce errors if access to high-alert drugs is not restricted.
A patient’s nutritional intake and lab work reflects hypoalbuminemia. This is critical to prescribing because:
- A. Distribution of drugs to target tissue may be affected
- B. The solubility of the drug will not match the site of absorption
- C. There will be less free drug available to generate an effect
- D. Drugs bound to albumin are readily excreted by the kidney
Correct Answer: C
Rationale: Rationale for Correct Answer C:
1. Albumin is a major plasma protein that binds to drugs.
2. Hypoalbuminemia means less albumin is available to bind drugs.
3. Less albumin results in more free drug in the bloodstream.
4. Free drug is pharmacologically active and can generate effects.
5. Therefore, with less albumin, less free drug is available to generate an effect.
Summary:
A: Distribution of drugs may be affected by protein binding, not albumin levels.
B: Solubility matching absorption sites is more related to drug formulation.
D: Albumin-bound drugs are not readily excreted by the kidney; they are protected from filtration.
What term best defines the cimetidine-diazepam interaction where the sedative effect of diazepam increased significantly?
- A. Synergism
- B. Potentiation
- C. Additive
- D. Antagonism
Correct Answer: B
Rationale: The cimetidine-diazepam interaction, where the sedative effect of diazepam increased significantly due to the inhibition of the cytochrome P-450 system by cimetidine, can be best defined as potentiation. Potentiation refers to the enhancement of one drug's effect by another, leading to a greater overall effect than either drug alone. In this case, cimetidine potentiates the sedative effect of diazepam by inhibiting its metabolism, resulting in increased sedation.
Which drug is formulated to be absorbed through the skin? Select all that apply.
- A. Lidocaine
- B. Clonidine
- C. Propranolol
- D. Nitroglycerin
Correct Answer: A
Rationale: The correct answer is A: Lidocaine. Lidocaine is formulated as a transdermal patch for skin absorption. It has a lipophilic structure and low molecular weight, facilitating its penetration through the skin layers. Clonidine and Propranolol are typically administered orally or intravenously, not through the skin. Nitroglycerin is also formulated for skin absorption, often used in patches for angina treatment. However, in this question, the focus is on which drug is specifically formulated for skin absorption, making Lidocaine the most appropriate choice.