Nokea
Which of the following create a higher risk for digoxin toxicity? Both the cause and the reason for it must be correct.
- A. Older adults because of reduced renal function
- B. Administration of aldosterone antagonist diuretics because of decreased potassium levels
- C. Taking an antacid for gastroesophageal reflux disease because it increases the absorption of digoxin
- D. Doses between 0.25 and 0.5 mg/day
Correct Answer: A
Rationale: Older adults have reduced renal clearance, increasing digoxin toxicity risk.
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In the presence of naloxone, a higher concentration of morphine is required to elicit full pain relief. Naloxone by it self has no effect. Which of the following is correct regarding these medications?
- A. Naloxone is a competitive antagonist
- B. Morphine is a full agonist, and naloxone is a partial agonist
- C. Morphine is less efficacious than is naloxone
- D. Morphine is less potent than is naloxone
Correct Answer: A
Rationale: Naloxone shifts morphine's dose-response curve rightward (increased EC50), typical of competitive antagonism, with no intrinsic effect.
A patient who is unconscious arrives in the emergency department with clammy skin and constricted pupils. The nurse assesses a respiratory rate of 8 to 10 breaths per minute. The paramedics report obvious signs of drug abuse in the patient's home. The nurse suspects that this patient has had an overdose of which substance?
- A. Alcohol
- B. LSD
- C. An opioid
- D. Methamphetamine
Correct Answer: C
Rationale: Opioid overdose causes miosis and respiratory depression; alcohol or meth differ. Opioid overdose is characterized by constricted pupils and respiratory depression.
The patient is taking low dose aspirin daily for his heart. The nurse knows only a portion of the medication taken actually reaches the tissue due to what process?
- A. Distribution
- B. First-pass effect
- C. Reduced absorption
- D. Gastrointestinal circulation
Correct Answer: B
Rationale: Drugs that are taken orally are usually absorbed from the small intestine directly into the portal venous system and then delivers these absorbed molecules into the liver, which immediately break the drug into metabolites, some of which are active and cause effects in the body, and some of which are deactivated and can be readily excreted from the body. As a result, a large percentage of the oral dose is destroyed at this point and never reaches the tissues. This process is not caused by distribution, absorption, or gastrointestinal circulation.
The MMR vaccine is not recommended for pregnant women because:
- A. Pregnant women do not build adequate immunity to the vaccine
- B. There is a risk of the pregnant women developing measles encephalopathy
- C. There is a risk of the fetus developing congenital rubella syndrome
- D. Pregnant women can receive the MMR vaccine
Correct Answer: C
Rationale: MMR (live vaccine) risks fetal congenital rubella syndrome ; pregnancy contraindicates it, not immunity or encephalopathy .
When reviewing information about the Orphan Drug Program, which of the following would the nurse expect to find? (Select one that does not apply.)
- A. The program encourages the development and marketing of products to treat rare diseases.
- B. The program grants provisional approval with a written commitment from the drug company to formally demonstrate client benefits.
- C. The program provides for incentives, such as research grants, protocol assistance, and special tax credits, to develop products to treat rare diseases.
- D. The program grants 7 years of exclusive marketing rights to the manufacturer if approved.
Correct Answer: B
Rationale: The Orphan Drug Program encourages the development and marketing of products used to treat rare diseases. The program provides incentives to encourage manufacturers to develop orphan drugs, and if approved, the manufacturer has 7 years of exclusive marketing rights. Accelerated programs involve provisional approval and approval based on preliminary evidence.