Nokea
Which of the following is an insulin effect in the liver:
- A. Inhibition of glycogenolisis
- B. Inhibition of glycolysis
- C. Decrease of glycogenesis
- D. Decreases of pyruvatkinase, phosphofructokinase and glucokinase activity
Correct Answer: A
Rationale: Insulin inhibits glycogenolysis in the liver, promoting glucose storage as glycogen rather than its breakdown.
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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.
Which of the following produced by the pancreatic beta cells:
- A. Insulin
- B. Gastrin
- C. Somatostatin
- D. Glucagon
Correct Answer: A
Rationale: Insulin is secreted by pancreatic beta cells to lower blood glucose.
A nurse working in an emergency department is caring for a client who has Benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority?
- A. Administer flumazenil.
- B. Identify the client's level of orientation.
- C. Infuse IV fluids.
- D. Prepare the client for gastric lavage
Correct Answer: B
Rationale: Assessing orientation is the priority to determine the severity of toxicity and guide interventions.
The following drug when used for prolonged period in the maintenance treatment of tonic-clonic seizures can lead to increased metabolism of warfarin like drugs:
- A. Phenobarbitone
- B. Meprobamate
- C. Chlordiazepoxide
- D. Triazolam
Correct Answer: A
Rationale: Phenobarbitone induces CYP450, increasing warfarin metabolism.
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.