Nokea
Which of the following is the longest acting newer antihistamine:
- A. Mequitazine
- B. Loratidine
- C. Astemizole
- D. Terfenadine
Correct Answer: C
Rationale: Astemizole has the longest duration among listed antihistamines.
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A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages?
- A. Increased renal secretion
- B. Increased medication-metabolizing enzymes
- C. Liver failure
- D. Peripheral vascular disease
Correct Answer: C
Rationale: Liver failure impairs metabolism, and concurrent use of medications metabolized by the same pathway can increase drug levels, both necessitating lower doses.
A physician order is written for a patient to receive 500 mL of normal saline IV over 8 hours. If the IV infusion set delivers 15 drops/mL, how many drops per minute should the patient receive?
- A. 15 drops/min
- B. 20 drops/min
- C. 32 drops/min
- D. 64 drops/min
Correct Answer: A
Rationale: If a patient were to receive 500 mL in 8 hours, dividing 500 by 8 would mean that the patient would receive 62.5 mL in 1 hour, or 60 minutes. Setting up the equation, 15 drops/mL/X = 62.5 mL/60 minutes, and cross-multiplying, the answer will be 15 drops/min.
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.
Following drugs have disulfiram-like reaction when taken with alcohol EXCEPT
- A. Sulfonylureas
- B. Amoxicillin
- C. Metronidazole
- D. Cefoperazone
Correct Answer: B
Rationale: Metronidazole, cefoperazone, and some sulfonylureas cause a disulfiram-like reaction (flushing, nausea) with alcohol by inhibiting aldehyde dehydrogenase; amoxicillin does not.
Elimination after 4 half lives in first order kinetics is
- A. 84%
- B. 93%
- C. 80.50%
- D. 4.75%
Correct Answer: B
Rationale: After 4 half-lives, 93.75% (1 - 1/16) of the drug is eliminated in first-order kinetics.