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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Immune globulin serums:
- A. Provide active immunity against infectious diseases
- B. Are contraindicated during pregnancy
- C. Are heated to above body temperature to kill most hepatitis, HIV, and other viruses such as parvovirus
- D. Are derived from pooled plasma of adults and contain specific antibodies in proportion to the donor population
Correct Answer: D
Rationale: Immune globulins are passive immunity from pooled plasma; they're not active , not contraindicated in pregnancy , and not heated .
The patient is taking a drug that affects the body by increasing cellular activity. Where does this drug work on the cell?
- A. Receptor sites
- B. Cell membrane
- C. Golgi body
- D. Endoplasmic reticulum
Correct Answer: A
Rationale: Many drugs are thought to act at specific areas on cell membranes called receptor sites. After the receptor site is activated, this in turn activates the enzyme systems to produce certain effects, such as increased or decreased cellular activity, changes in cell membrane permeability, or alterations in cellular metabolism. Receptor sites are generally located on the outside of cells and allow the drug to bypass the cell membrane. The Golgi body and endoplasmic reticulum are not involved in this process.
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.
Abrupt withdrawal of beta blockers can be life threatening. Patients at highest risk for serious consequences of rapid withdrawal are those with:
- A. Angina
- B. Coronary artery disease
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: C
Rationale: Patients with angina and CAD are at high risk for rebound effects like myocardial infarction.
A nurse is completing a nursing history for a client who takes Simvastatin. The nurse should identify which of the following disorders as a contraindication to adding Ezetimibe to the client's medications?
- A. History of severe constipation
- B. History of hypertension
- C. Active hepatitis C
- D. Type 2 diabetes mellitus
Correct Answer: C
Rationale: Active hepatitis C contraindicates ezetimibe due to increased liver risk with statins.