Nokea
Which of the following is natural mineralcorticoid:
- A. Methylprednisolone
- B. Betamethasone
- C. Triamcinolone
- D. Aldosterone
Correct Answer: D
Rationale: Aldosterone is the natural mineralocorticoid produced by the adrenal cortex.
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Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
- A. OTC drugs are safe and do not cause adverse effects if taken properly.
- B. OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).
- C. OTC drugs are different from any drugs available by prescription and cost less.
- D. OTC drugs could cause serious harm if not taken according to directions.
Correct Answer: D
Rationale: It is important to follow package directions because OTCs are medications that can cause serious harm if not taken properly. OTCs are drugs that have been determined to be safe when taken as directed; however, all drugs can produce adverse effects even when taken properly. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC education should always be included as a part of the hospital discharge instructions.
Prescribers have been shown to override a medication alert about a patient's allergies when:
- A. The history showed that the patient had tolerated the medication in the past
- B. The benefit outweighed the risk
- C. The medication was therapeutically appropriate and needed
- D. All of the above
Correct Answer: D
Rationale: Prescribers may override alerts if past tolerance, benefit-risk balance, or therapeutic need justifies it.
A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
- A. The impact of the placebo effect on the patient's response.
- B. The accumulative effect of the drug if it has been taken for many years.
- C. The impact of the warmer environment on the patient's physical status.
- D. Problems with patient compliance with the drug regimen while on vacation.
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and moves to a warmer climate, there is a chance that the patient's blood pressure will drop too low, resulting in dizziness and feelings of weakness. Even mild dehydration could exacerbate these effects. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
Patients should be instructed regarding the rapid onset of zolpidem (Ambien) because:
- A. Zolpidem should be taken just before going to bed.
- B. Zolpidem may cause dry mouth and constipation.
- C. Patients may need to double the dose for effectiveness.
- D. They should stop drinking alcohol at least 30 minutes before taking zolpidem.
Correct Answer: A
Rationale: Zolpidem's rapid onset requires bedtime administration to prevent falls or amnesia.
Angina pectoris, tachycardia, and arrhythmias are possible adverse effects of which of the following drugs?
- A. Clonidine
- B. Phenylephrine
- C. Propranolol
- D. Salbutamol
Correct Answer: D
Rationale: Salbutamol, a beta-2 agonist, can cause cardiac stimulation as a side effect.