Nokea
Which of the following MAO inhibitors has amphetamine-like activity and is related to nonhydrazide derivatives:
- A. Phenelzine
- B. Moclobemide
- C. Tranylcypramine
- D. All of the above
Correct Answer: C
Rationale: The correct answer is C: Tranylcypramine. Tranylcypramine is a nonhydrazide derivative of MAO inhibitor that has amphetamine-like activity due to its structural similarity to amphetamines. Phenelzine and Moclobemide are not related to nonhydrazide derivatives and do not exhibit amphetamine-like activity. Therefore, the correct choice is C.
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A patient who takes lithium phones the nurse at the clinic to say, “I’ve had diarrhea for 4 days. I feel weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?” Which instruction by the nurse is appropriate?
- A. “Have someone bring you to the clinic immediately.”
- B. “Restrict food and fluids for 24 hours and stay in bed.”
- C. “Drink a large glass of water with 1 teaspoon of salt added.”
- D. “Take antidiarrheal medication hourly until the diarrhea subsides.”
Correct Answer: A
Rationale: The correct answer is A: "Have someone bring you to the clinic immediately." This is the appropriate instruction because the patient is experiencing symptoms of lithium toxicity, such as diarrhea, weakness, unsteadiness, and worsening hand tremor. Lithium toxicity is a serious condition that can lead to life-threatening complications if not treated promptly. Bringing the patient to the clinic immediately allows for proper evaluation, monitoring, and treatment by healthcare professionals.
Summary:
- Choice B: "Restrict food and fluids for 24 hours and stay in bed" is incorrect as it does not address the urgency of the situation and may worsen dehydration.
- Choice C: "Drink a large glass of water with 1 teaspoon of salt added" is incorrect as it can exacerbate the electrolyte imbalance caused by lithium toxicity.
- Choice D: "Take antidiarrheal medication hourly until the diarrhea subsides" is incorrect as it does not address the root cause of the symptoms and may delay necessary medical intervention.
Class of tacrolimus (FK-506) is:
- A. Immunoglobulins
- B. Immunosuppressive agents
- C. Interferons
- D. Monoclonal antibodies
Correct Answer: B
Rationale: The correct answer is B: Immunosuppressive agents. Tacrolimus (FK-506) belongs to this class as it suppresses the immune system. It is commonly used in transplant patients to prevent organ rejection by inhibiting T-cell activation. Immunoglobulins (A) are antibodies produced by the immune system. Interferons (C) are signaling proteins released by cells in response to pathogens. Monoclonal antibodies (D) are antibodies produced by identical immune cells and used for targeted therapies. Therefore, the most appropriate classification for tacrolimus is as an immunosuppressive agent due to its mechanism of action and therapeutic use in modulating the immune response.
Following drugs directly activate the respiratory center EXCEPT:
- A. Bemegride
- B. Caffeine
- C. Aethymizole
- D. Cytiton
Correct Answer: D
Rationale: The correct answer is D: Cytiton. The respiratory center is primarily stimulated by drugs that act on the central nervous system. Cytiton is not known to directly activate the respiratory center. Bemegride, caffeine, and aethymizole are central nervous system stimulants that can directly activate the respiratory center. Caffeine, for example, is a respiratory stimulant and can increase respiratory rate. Aethymizole is used to treat respiratory depression caused by opioid overdose. Bemegride is a respiratory stimulant used to treat respiratory depression. Therefore, D is the correct answer as it is not a drug known to directly activate the respiratory center.
The client has a myocardial infarction and going into shock. What might be a medication to give to counteract shock in cases of myocardial infarction?
- A. Atropine
- B. Dopamine
- C. Digoxin
- D. Adenosine
Correct Answer: B
Rationale: Dopamine, a vasopressor and inotrope, is used in cardiogenic shock post-MI to improve blood pressure and cardiac output.
The drug can be used to treat nephrogenic diabetes insipidus:
- A. Hydrochlorothiazide (HydroDiuril)
- B. Amiloride (Midamor)
- C. Both of the above
- D. Neither of the above
Correct Answer: A
Rationale: Step-by-step rationale for why choice A (Hydrochlorothiazide) is correct:
1. Hydrochlorothiazide is a thiazide diuretic that decreases urine volume by increasing water reabsorption.
2. In nephrogenic diabetes insipidus, the kidneys are unable to respond to antidiuretic hormone (ADH), causing excessive urine production.
3. Hydrochlorothiazide can help reduce urine output by enhancing water reabsorption, thus alleviating symptoms of nephrogenic diabetes insipidus.
Summary of other choices:
- Choice B (Amiloride) is a potassium-sparing diuretic that does not directly address the underlying mechanism of nephrogenic diabetes insipidus.
- Choice C (Both of the above) is incorrect as only Hydrochlorothiazide is indicated for treating nephrogenic diabetes insipidus.
- Choice D (Neither of the above) is incorrect as Hydrochlorothiazide is indeed