Nokea
Which of the following beta receptor antagonists is preferable in patients with asthma diabetes or peripheral vascular diseases?
- A. Propranolol
- B. Metoprolol
- C. Nadolol
- D. Timolol
Correct Answer: B
Rationale: The correct answer is B: Metoprolol. Metoprolol is a cardioselective beta blocker, meaning it primarily targets beta-1 receptors in the heart and has minimal effect on beta-2 receptors in the lungs. This makes it preferable in patients with asthma as it reduces the risk of bronchoconstriction compared to non-selective beta blockers like Propranolol (choice A). Metoprolol also has a lower risk of masking hypoglycemic symptoms in diabetic patients compared to non-selective agents. Nadolol (choice C) and Timolol (choice D) are non-selective beta blockers and may worsen asthma and peripheral vascular diseases due to their effects on beta-2 receptors.
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Tick the group of drugs used as subsidiary medicines in cancer treatment:
- A. Cytoprotectors
- B. Bone marrow growth factors
- C. Antimetastatic agents
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Cytoprotectors help protect healthy cells from damage caused by cancer treatment. Bone marrow growth factors aid in stimulating the production of blood cells, which can be suppressed during cancer treatment. Antimetastatic agents help prevent the spread of cancer to other parts of the body. Therefore, all these groups of drugs are used as subsidiary medicines in cancer treatment to support the primary treatment and manage side effects. Choices A, B, and C are incorrect individually because each group plays a specific role in supporting cancer treatment, making the combination of all three necessary for comprehensive care.
The nurse is reviewing the food choices of a patient who is taking a monoamine oxidase inhibitor (MAOI). Which food choice would indicate the need for additional teaching?
- A. Orange juice
- B. Fried eggs over-easy
- C. Salami and Swiss cheese sandwich
- D. Biscuits and honey
Correct Answer: C
Rationale: The correct answer is C: Salami and Swiss cheese sandwich. This is because salami and Swiss cheese are high in tyramine, which can cause a hypertensive crisis in patients taking MAOIs due to their inhibitory effect on monoamine oxidase. Orange juice (A) does not contain tyramine. Fried eggs over-easy (B) and biscuits with honey (D) are also safe choices as they do not contain high levels of tyramine. Therefore, the need for additional teaching is indicated by the selection of foods high in tyramine like salami and Swiss cheese.
Indicate an antiseizure drug that is a sodium channel blocker and is used as an adjunctive therapy for partial and generalized seizures:
- A. Carbamazepine
- B. Lacosamide
- C. Ethosuximide
- D. Lamotrigine
Correct Answer: B
Rationale: Rationale:
1. Lacosamide is a sodium channel blocker, working by enhancing slow inactivation of voltage-gated sodium channels.
2. It is used as an adjunctive therapy for partial-onset seizures in adults.
3. Lacosamide is also approved for the treatment of generalized seizures in certain patients.
4. Carbamazepine (A) is a sodium channel blocker but is primarily used for focal seizures.
5. Ethosuximide (C) is a T-type calcium channel blocker used for absence seizures.
6. Lamotrigine (D) is a sodium channel blocker but is mainly used for focal and generalized seizures, not as an adjunctive therapy.
Which of the following statements refers to 1,25-dihydroxyvitamin D3 (calcitriol):
- A. The combined effect of calcitriol and all other vitamin D metabolites and analogs on both calcium and phosphate makes careful monitoring of the level of these minerals especially important to avoid ectopic calcification
- B. Does not undergo enterohepatic circulation
- C. Toxic to osteoclasts
- D. Bioavailability increases with the administered dose
Correct Answer: A
Rationale: Rationale:
A: Correct. Calcitriol regulates calcium and phosphate levels, leading to potential ectopic calcification. Monitoring is crucial.
B: Incorrect. Calcitriol does undergo enterohepatic circulation.
C: Incorrect. Calcitriol is not toxic to osteoclasts; it has a role in bone health.
D: Incorrect. Calcitriol has a complex relationship with bioavailability, affected by several factors.
Indicate the drug belonging to fibrinoliytic inhibitors:
- A. Aminocapronic acid
- B. Ticlopidine
- C. Streptokinase
- D. Vitamin K
Correct Answer: A
Rationale: Step-by-step rationale for why Aminocaproic acid (A) is the correct answer:
1. Aminocaproic acid is a fibrinolytic inhibitor that prevents the breakdown of blood clots.
2. It works by inhibiting the activation of plasminogen to plasmin, which is essential for clot dissolution.
3. Therefore, Aminocaproic acid belongs to the class of fibrinolytic inhibitors.
Summary of why the other choices are incorrect:
- Ticlopidine (B) is a platelet aggregation inhibitor, not a fibrinolytic inhibitor.
- Streptokinase (C) is a fibrinolytic drug that promotes clot breakdown, not an inhibitor.
- Vitamin K (D) is essential for clotting factors synthesis, not a fibrinolytic inhibitor.