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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It is customary to administer systemic corticosteroids early in the morning because:
- A. This prevents early morning bronchospasms
- B. To inhibit adrenocorticotrophic hormone over secretion
- C. To achieve high plasma concentrations throughout the day
- D. To prevent adrenocortex suppression
Correct Answer: D
Rationale: Morning dosing aligns with cortisol peaks, minimizing adrenal suppression.
The nurse is assessing a diabetic patient who has presented at the clinic reporting several hypoglycemic episodes during the past 3 weeks. The nurse questions the patient about the use of herbal or alternative therapies, suspecting what herbal remedy could cause the hypoglycemic episodes?
- A. St. John's wort
- B. Kava
- C. Fish oil
- D. Ginseng
Correct Answer: D
Rationale: Ginseng is known to decrease blood sugar levels. If the patient used this in combination with his or her oral antidiabetic agent, diet, and exercise, his or her blood sugar could drop below therapeutic levels. St. John's wort interacts with many drugs, but not with antidiabetic agents. Kava is associated with liver toxicity. Fish oil has been associated with decreased coronary artery disease.
Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol. You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related to his nadolol?
- A. Extend the dosage interval.
- B. Decrease the dose by 75%.
- C. Take no action because this value is expected in the older adult.
- D. Schedule a serum creatinine level to validate the CrCl value.
Correct Answer: A
Rationale: Reduced renal clearance (CrCl 25 ml/min) requires extending the dosage interval for nadolol.
All of the following adverse effects commonly occur in glucocorticoid therapy except:
- A. Osteoporosis
- B. Increased risk of infection
- C. Hypotension
- D. Emotional disturbances
Correct Answer: C
Rationale: Glucocorticoids cause hypertension, not hypotension, due to mineralocorticoid effects and fluid retention.
Which one of the following statements is NOT true of warfarin?
- A. It is extensively 99% bound to plasma albumin
- B. Its use in pregnant women is contraindicated because it is teratogenic
- C. It is active in vitro
- D. Its induced bleeding can be conteracted by treatment with phytonadione
Correct Answer: C
Rationale: Warfarin acts in vivo by inhibiting vitamin K epoxide reductase, not in vitro; thus, is false.