When assessing a patient before starting a drug regimen, why would the nurse consider it important to assess baseline kidney function?
- A. To anticipate adverse effects of drugs
- B. To determine patient's baseline electrolyte levels
- C. To determine patient's ability to excrete the drug
- D. To determine patient's ability to metabolize the drug
Correct Answer: C
Rationale: Kidney function determines drug excretion, critical for dosing and avoiding toxicity.
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The patient tells the nurse about a new drug being tested to treat the disease she was diagnosed with and asks the nurse whether the doctor can prescribe a medication still in the preclinical phase of testing. What is the nurses best response?
- A. The doctor would have to complete a great deal of paperwork to get approval to prescribe that drug.
- B. Sometimes pharmaceutical companies are looking for volunteers to test a new drug and the doctor could give them your name.
- C. Drugs in the preclinical phase of testing are only tested on animals and so would not be available to you.
- D. Drugs in the preclinical phase of testing are given only to healthy young men and so would not be available to you.
Correct Answer: C
Rationale: During the preclinical phase of testing drugs are tested on animals and are not available to patients. In phase I, the drug is tested on volunteers who are usually healthy young men. It is only in phase III studies that the drug is made available to prescribers who agree to closely monitor patients getting the medication.
Which of the following shows high first pass metabolism:
- A. Propranolol
- B. Phenobarbitone
- C. Phenylbutazone
- D. Phenytoin
Correct Answer: A
Rationale: Propranolol undergoes extensive first-pass metabolism in the liver.
Beta-blockers decrease nocturnal melatonin release, thereby contributing to sleep disturbances.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: Beta-blockers, especially lipophilic ones, reduce melatonin release, potentially causing sleep disturbances.
A patient is diagnosed with histoplasmosis and will begin taking ketoconazole. What information will the nurse include when teaching this patient about this medication?
- A. Take the medicine twice daily
- B. Take the medication with food
- C. You may consume small amounts of alcohol
- D. You will not need lab tests while taking this drug
Correct Answer: B
Rationale: Ketoconazole absorption improves with food; it's once daily, and alcohol or no labs are incorrect. Ketoconazole should be taken with food.
Select the first choice drug for acute gout:
- A. Colchicine
- B. Indomethacin
- C. Allopurinol
- D. Dexamethasone
Correct Answer: B
Rationale: Indomethacin, an NSAID, is the first-line treatment for acute gout due to its rapid anti-inflammatory action; colchicine is an alternative, while allopurinol is for prophylaxis.
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