When determining drug treatment, the NP prescriber should:
- A. Always use evidence-based guidelines
- B. Individualize the drug choice for the specific patient
- C. Rely on his or her experience when prescribing for complex patients
- D. Use the newest drug on the market for the condition being treated
Correct Answer: B
Rationale: Individualizing treatment tailors therapy to the patient, balancing evidence and experience , while avoiding untested new drugs .
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A patient is being seen in the clinic for rheumatoid arthritis. Which of the following statements would indicate that she may be developing a complication from her rheumatoid medication, chloroquine (Aralen)?
- A. I have to urinate all the time.'
- B. Sometimes I have blurred vision.'
- C. I have tingling and numbness in my arms and legs.'
- D. Sometimes I feel like I am losing my balance when I walk.'
Correct Answer: B
Rationale: Chloroquine (Aralen) can cause ocular toxicity with blurring of vision, color vision changes, corneal damage, and blindness. Increased urination and tingling and numbness are signs of hyperkalemia and hypokalemia. Loss of balance can be caused by auditory damage due to drug toxicity.
Pick the true statement:
- A. Amox- Clavulanic, Clavulanic increases amox activity
- B. Sublactum is used in treatment of Leprosy
- C. Aztreonam is a metabolite of clarithromycin
- D. Cilastatin imipenam- cilastatin prevents hydrolysis of imipenam
Correct Answer: B
Rationale: Sulbactam is used in leprosy treatment; other statements are incorrect (e.g., clavulanic enhances amoxicillin, cilastatin protects imipenem).
Rodrigo has been prescribed procainamide after a myocardial infarction. He is monitored for dyspnea, jugular venous distention, and peripheral edema because they may indicate:
- A. Widening of the area of infarction
- B. Onset of congestive heart failure
- C. An electrolyte imbalance involving potassium
- D. Renal dysfunction
Correct Answer: B
Rationale: These symptoms suggest heart failure, a potential procainamide complication.
A 49-year-old woman with a history of hypertension is treated with spironolactone. She has good blood pressure control and in the last 6 months has shown an improvement in her hirsutism. What is the most likely explanation for these findings?
- A. Androgen receptor inhibition of the hair follicle
- B. Drug toxicity
- C. Hypoaldosteronism
- D. Testosterone levels are elevated
Correct Answer: A
Rationale: Spironolactone's anti-androgenic effects inhibit androgen receptors, reducing hirsutism, alongside its aldosterone antagonism for hypertension.
Which of the following is natural mineralcorticoid:
- A. Methylprednisolone
- B. Betamethasone
- C. Triamcinolone
- D. Aldosterone
Correct Answer: D
Rationale: Aldosterone is the natural mineralocorticoid regulating sodium and potassium balance.