Nokea
Which of the following statements about beta-blockers is false?
- A. Beta-blockers should be avoided with non-dihydropyridine calcium channel blockers
- B. Beta-blockers increase renin secretion
- C. Non-selective beta-blockers are contraindicated in asthma
- D. Beta-blockers prolong the refractory period of the AV node
Correct Answer: B
Rationale: Beta-blockers decrease renin secretion by blocking beta-1 receptors in the kidney, making this statement false.
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What is a prodrug
- A. Drag which increases efficiency of another drug
- B. Metabolic end product
- C. Inactive drag which gets activated in the body
- D. Drag which competes with another for metabolism
Correct Answer: C
Rationale: A prodrug is inactive until metabolized into an active form in the body.
A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy Category B drug. What would the nurse inform the patient?
- A. Adequate studies in pregnant women have demonstrated there is no risk to the fetus.
- B. Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women.
- C. Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant women.
- D. There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks.
Correct Answer: B
Rationale: Category B indicates that animal studies have not demonstrated a risk to the fetus. However, there have not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of pregnancy and no evidence of risk in later trimesters. Category A indicates that adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters. Category C indicates that animal studies have shown an adverse effect on the fetus, but no adequate studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the use of the drugs in pregnant women may outweigh potential risks.
Juanita had a deep vein thrombosis (DVT) and was on heparin in the hospital and was discharged on warfarin. She asks her primary care provider NP why she was getting both medications while in the hospital. The best response is to:
- A. Contact the hospitalist as this is not the normal guideline for prescribing these two medications and she may have had a more complicated case
- B. Explain that warfarin is often started while a patient is still on heparin because warfarin takes a few days to reach effectiveness
- C. Encourage the patient to contact the Customer Service department at the hospital as this was most likely a medication error during her admission
- D. Draw anticoagulation studies to make sure she does not have dangerously high bleeding times
Correct Answer: B
Rationale: Warfarin's delayed onset requires heparin overlap for immediate anticoagulation; this is standard, not an error or exception .
Which of the following sign/symptom would NOT be expected from organophosphate poisoning?
- A. Dry skin and mucous membranes
- B. Increased salivation
- C. Increased bowel sounds
- D. Urinary urgency
Correct Answer: A
Rationale: Organophosphates cause wet symptoms (salivation, etc.); dry skin is typical of anticholinergics.
True contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include:
- A. Fever up to 104°F (40.5°C) after previous DTaP vaccine
- B. Family history of seizures after DTaP vaccine
- C. Adolescent pregnancy
- D. Anaphylactic reaction with a previous dose
Correct Answer: D
Rationale: Anaphylaxis is a true contraindication to DTaP/Tdap; fever , family history , or pregnancy are not.