Which of the following NSAIDs has greater inhibitory selectivity for COX-1 than COX-2?
- A. Flurbiprofen
- B. Indomethacin
- C. Diclofenac
- D. Celecoxib
Correct Answer: B
Rationale: Indomethacin is more selective for COX-1, whereas celecoxib is COX-2 selective; others have mixed activity.
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A 50-year-old woman has just been diagnosed with type 2 diabetes and given a prescription for metformin. Which of the following statements is characteristic of this medication?
- A. Metformin is inappropriate for initial management of type 2 diabetes
- B. Metformin decreases hepatic glucose production
- C. Metformin undergoes significant metabolism via the cytochrome P450 system
- D. Weight gain is a common adverse effect
Correct Answer: B
Rationale: Metformin reduces hepatic glucose production, a key mechanism in managing type 2 diabetes, and is often a first-line treatment.
A patient is receiving digoxin as treatment for heart failure. Which of the following would be most important for the nurse to monitor to reduce the risk for toxicity?
- A. Seizure activity
- B. Drug blood level
- C. Urinary output
- D. Blood pressure
Correct Answer: B
Rationale: The nurse should monitor the patient's blood level of the drug to ensure that the level remains within the therapeutic range. Monitoring seizure activity, urination frequency, and blood pressure will not prevent toxicity. Seizure activity is unrelated to digoxin or heart failure.
All of following are examples of prodrugs except
- A. Levodopa
- B. Enlapril
- C. Omeprazole
- D. Indomethacin
Correct Answer: D
Rationale: Prodrugs (e.g., levodopa, enalapril, omeprazole) are inactive until metabolized. Indomethacin is active as administered.
The nurse explains the Drug Enforcement Agencys (DEAs) schedule of controlled substances to the nursing assistant who asks, Do you ever get a prescription for Schedule I medications? What is the nurses best response?
- A. Schedule I medications have no medical use so they are not prescribed.
- B. Schedule I medications have the lowest risk for abuse and do not require a prescription.
- C. Schedule I medications are only prescribed in monitored units for patient safety.
- D. Schedule I medications are found in antitussives and antidiarrheals sold over the counter.
Correct Answer: A
Rationale: Schedule I medications have no medical use and are never prescribed. Schedule V medications have the lowest risk for abuse and are found mostly in antitussives and antidiarrheals but they are not sold over the counter.
Azathioprine has significant adverse drug effects, including:
- A. Hypertension
- B. Hirsutism
- C. Risk of cancer
- D. Gingival hyperplasia
Correct Answer: C
Rationale: Azathioprine increases cancer risk (e.g., lymphoma) via immunosuppression; other effects (A, B, D) are less prominent.
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