Nokea
Which of the following drugs is NOT an aminoglycoside?
- A. Streptomycin
- B. Neomycin
- C. Amikacin
- D. Azithromycin
Correct Answer: D
Rationale: Azithromycin is a macrolide antibiotic, not an aminoglycoside, unlike the others listed.
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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.
When prescribing NSAIDS, a complete drug history should be conducted as NSAIDs interact with these drugs:
- A. Omeprazole, a proton pump inhibitor
- B. Combined oral contraceptives
- C. Diphenhydramine, an antihistamine
- D. Warfarin, an anticoagulant
Correct Answer: D
Rationale: NSAIDs increase bleeding risk with warfarin; interactions with PPIs or contraceptives are less significant.
You are going to prescribe a drug and the electronic health record (EHR) alerts you that there is a potential drug-drug interaction. The alert is generated by:
- A. The Food and Drug Administration MedWatch system
- B. TOXNET, the National Institutes of Health alert system
- C. The EHR clinical decision support system
- D. Lexicomp, a commercial medication alert system
Correct Answer: C
Rationale: EHR clinical decision support systems generate real-time drug interaction alerts.
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.
Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?
- A. Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action.
- B. Additive antimuscarinic effects may occur with antihistamines.
- C. Cholinergic blockers may decrease the sedative effects of hypnotics.
- D. Cholinergic blockers are contraindicated with antipsychotics.
Correct Answer: B
Rationale: Additive antimuscarinic effects with antihistamines can enhance side effects like sedation.