Nokea
Which of the following avoids first pass effect of drugs
- A. Oral ingestion
- B. Rectal Suppository
- C. Intra venous injection
- D. Intra-arterial injection
Correct Answer: D
Rationale: Intra-arterial injection bypasses the liver, avoiding first-pass metabolism.
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You are caring for a patient who takes several drugs. You know that those patients most likely to have adverse drug reactions are who?
- A. Patients with coronary artery disease
- B. Non-compliant patients
- C. Patients who are on the recommended dose
- D. Very young and very old patients
Correct Answer: D
Rationale: Very young and old patients have immature or declining organ function, increasing adverse reaction risk.
The patient looks at the prescription provided by the doctor and asks the nurse whether he can request a generic substitution. The nurse answers No when noting what on the prescription?
- A. No refills
- B. DAW
- C. Brand name used on prescription
- D. Patient older than 65 years of age
Correct Answer: B
Rationale: DAW stands for dispense as written and means that the doctor does not want a generic substituted for the prescribed medication. Requesting no refills does not preclude the substitution of a generic medication. Even when the brand name is ordered, the pharmacist can substitute a generic equivalent so long as the prescriber does not write DAW. Generic substitutions are not impacted by the patient's age.
Which of the following statements CORRECTLY describes the mechanism of action of imatinib mesylate in chronic myeloid leukemia:
- A. Inhibitor of tyrosine kinase
- B. Inhibitor of topoisomerase 1
- C. Inhibitor of topoisomerase 2
- D. It is an alkylating agent
Correct Answer: A
Rationale: Imatinib inhibits BCR-ABL tyrosine kinase in CML.
A nurse is providing teaching to a client who has a new prescription for Digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation Digoxin toxicity? (Select one that does not apply.)
- A. Fatigue
- B. Constipation
- C. Anorexia
- D. Diplopia
Correct Answer: B
Rationale: Fatigue , anorexia , and diplopia are signs of digoxin toxicity.
A patient is using the Commit lozenge 2 mg to help quit smoking and reports nausea and indigestion. The nurse will instruct the patient to perform which action?
- A. Allow the lozenge to dissolve slowly over 20 to 30 minutes
- B. Chew the lozenge thoroughly before swallowing it
- C. Increase to 4 mg and use less often
- D. Take the lozenge with food and a full glass of water
Correct Answer: A
Rationale: Slow dissolution minimizes GI upset from nicotine lozenges; chewing worsens it. The patient should allow the lozenge to dissolve slowly.