Nokea
Which of the following is an II generation sulfonylurea drugs, which are used for the treatment of diabetes mellitus type II:
- A. Chlorpropamide
- B. Tolazamide
- C. Tobutamide
- D. Glipizide
Correct Answer: D
Rationale: Glipizide is a second-generation sulfonylurea, more potent and with fewer side effects than first-generation drugs like chlorpropamide.
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A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. After reaching the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.
A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should take which appropriate action?
- A. Notify the registered nurse.
- B. Administer pain medication to reduce the discomfort.
- C. Apply ice and maintain the infusion rate, as prescribed.
- D. Elevate the extremity of the IV site, and slow the infusion.
Correct Answer: A
Rationale: When antineoplastic medications (Chemotherapeutic Agents) are administered via IV, great care must be taken to prevent the medication from escaping into the tissues surrounding the injection site, because pain, tissue damage, and necrosis can result. The nurse monitors for signs of extravasation, such as redness or swelling at the insertion site and a decreased infusion rate. If extravasation occurs, the registered nurse needs to be notified; he or she will then contact the health care provider.
Robert, age 51 years, has been told by his primary care provider (PCP) to take an aspirin a day. Why would this be recommended?
- A. He has arthritis and this will help with the inflammation and pain
- B. Aspirin has anti-platelet activity and prevents clots that cause heart attacks
- C. Aspirin acidifies the urine and he needs this for prostate health
- D. He has a history of GI bleed, and one aspirin a day is a safe dosage
Correct Answer: B
Rationale: Aspirin's antiplatelet effect reduces cardiovascular risk, a common recommendation for men over 50; arthritis or prostate aren't primary reasons.
Donald has been diagnosed with hyperlipidemia. Based on his lipid profile, atorvastatin is prescribed. Rhabdomyolysis is a rare but serious adverse response to this drug. Donald should be told to:
- A. Become a vegetarian because this disorder is associated with eating red meat.
- B. Stop taking the drug if abdominal cramps and diarrhea develop.
- C. Report muscle weakness or tenderness and dark urine to his provider immediately.
- D. Expect 'hot flash' sensations during the first 2 weeks of therapy.
Correct Answer: C
Rationale: Muscle symptoms and dark urine indicate rhabdomyolysis, requiring immediate reporting.
The nurse administers an intravenous medication with a half-life of 24 hours but recognizes what factors in this patient could extend the drug's half-life? (Select one that does not apply.)
- A. Gastrointestinal disease
- B. Kidney disease
- C. Liver disease
- D. Cardiovascular disease
Correct Answer: A
Rationale: Kidney disease could slow excretion and extend the drug's half-life. Liver disease could slow metabolism resulting in an extended half-life. Cardiovascular disease could slow distribution resulting in a longer half-life. Gastrointestinal disease would not impact half-life because the medication was injected directly into the bloodstream. Route of administration would not extend half-life because IV injection eliminates the absorption step in the process.