Nokea
Which of the following statements CORRECTLY describes the mechanism of action of imatinib mesylate in chronic myeloid leukemia:
- A. Inhibitor of tyrosine kinase
- B. Inhibitor of topoisomerase 1
- C. Inhibitor of topoisomerase 2
- D. It is an alkylating agent
Correct Answer: A
Rationale: Imatinib inhibits BCR-ABL tyrosine kinase in CML.
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Jim presents with complaints of 'heartburn' that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would be:
- A. Omeprazole (Prilosec) twice a day
- B. Ranitidine (Zantac) twice a day
- C. Famotidine (Pepcid) once a day
- D. Metoclopramide (Reglan) four times a day
Correct Answer: B
Rationale: Ranitidine , an H2 blocker, is a standard first-line GERD treatment; PPIs are next-step, and metoclopramide is for motility.
A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient?
- A. Noncompliance: Cost of the drug
- B. Deficient knowledge: Unfamiliar with drug therapy
- C. Risk for injury: Related to adverse effects of the drug
- D. Ineffective health maintenance: Need for medication
Correct Answer: C
Rationale: Sedation increases the risk of falls or injury, making 'Risk for injury' the priority diagnosis over knowledge deficits or compliance issues.
A patient on a Class IV antiarrhythmic is experiencing bradycardia. Which medication is the patient most likely taking?
- A. Amiodarone
- B. Diltiazem
- C. Flecainide
- D. Lidocaine
Correct Answer: B
Rationale: Diltiazem, a Class IV calcium channel blocker, slows AV node conduction, commonly causing bradycardia.
Patients need to be instructed regarding the drug interactions with St John's wort, including:
- A. MAO inhibitors
- B. Serotonin reuptake inhibitors
- C. Over-the-counter cough and cold medications
- D. All of the above
Correct Answer: D
Rationale: St John's wort interacts with MAOIs, SSRIs (risk of serotonin syndrome), and OTC drugs via CYP450 induction.
Which of the following statements about pancreatic enzymes is true?
- A. Dosing may be titrated according to the decrease of steatorrhea
- B. The amount of carbohydrates in the meal drives the amount of enzyme used
- C. The amount of medication used is increased with a cystic fibrosis pulmonary flare
- D. The FDA and Internet-available formulations are bioequivalent
Correct Answer: A
Rationale: Pancreatic enzyme dosing adjusts based on steatorrhea reduction; carbs aren't the driver, and flares don't increase it.