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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Immunomodulators such as azathioprine may cause a delayed adverse drug reaction known as a type D reaction because they are known:
- A. Teratogens
- B. Carcinogens
- C. To cause hypersensitivity reactions
- D. Hypothalamus-pituitary-adrenal axis suppressants
Correct Answer: B
Rationale: Azathioprine's Type D (delayed) ADRs, like cancer risk , emerge long-term, unlike teratogenicity , hypersensitivity , or HPA suppression .
You are discussing your patient's drug regimen with their primary care provider. The patient has seen two specialists since seeing the primary care provider and been diagnosed with renal impairment. Why would this be important information? (Select one that does not apply.)
- A. Help promote a safe and effective medication regimen
- B. Help prevent medication errors
- C. So the physician can answer family questions
- D. Help prevent adverse effects
Correct Answer: C
Rationale: Renal impairment affects drug clearance, making this information vital to prevent errors , adverse effects , and ensure safety/efficacy . Keeping everyone informed and answering family questions are secondary.
A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions?
- A. Remove the prior dose before applying a new dose.
- B. Rub the ointment directly into your skin until it is no longer visible.
- C. Cover the applied ointment with a clean gauze pad.
- D. Apply the ointment to the same skin area each time.
Correct Answer: A
Rationale: Removing the prior dose prevents overdose and ensures accurate dosing.
A nurse is teaching the parents of a child who has a new prescription for Desipramine. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider?
- A. Constipation
- B. Suicidal thoughts
- C. Photophobia
- D. Dry mouth
Correct Answer: B
Rationale: Suicidal thoughts are a critical adverse effect of tricyclics like desipramine, requiring immediate reporting.
Which of the following class of agonists can precipitate hyperglycemia in diabetics?
- A. a 1-agonists
- B. α2-agonists
- C. β1-agonists
- D. β2-agonists
Correct Answer: D
Rationale: Beta-2 agonists (e.g., salbutamol) increase glycogenolysis, raising blood glucose.
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