Nokea
Which of the following two cyclooxygenase isoenzymes is constitutively expressed?
- A. COX-1
- B. COX-2
Correct Answer: A
Rationale: COX-1 is constitutively expressed in most tissues, maintaining normal functions, unlike inducible COX-2.
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When prescribing Adderall (amphetamine and dextroamphetamine) to adults with ADHD the nurse practitioner will need to monitor:
- A. Blood pressure
- B. Blood glucose levels
- C. Urine ketone levels
- D. Liver function
Correct Answer: A
Rationale: Adderall increases blood pressure, requiring monitoring.
Cruciferous vegetables may alter drug pharmacokinetics by:
- A. Enhancing absorption of weakly acidic drugs
- B. Altering CYP 3A4 activity, leading to elevated levels of drugs, such as the statins
- C. Inducing CYP 1A2, possibly leading to therapeutic failure of drugs metabolized by CYP 1A2
- D. Decreasing first-pass metabolism of drugs
Correct Answer: C
Rationale: Cruciferous vegetables (e.g., broccoli) induce CYP1A2, accelerating metabolism of drugs like theophylline, potentially reducing efficacy.
Which is known as the fifth vital sign?
- A. Temperature
- B. Respirations
- C. Pain
- D. Pulse
Correct Answer: C
Rationale: Pain is known as the fifth vital sign.
A patient has been using sleeping pills every night for the past several months. Now admitted to the hospital, he is prescribed his usual dose of sleeping pill. After administration, the patient continues to be restless and is wide awake. The nurse notifies the health care provider, who prescribes an increased dose. After receiving the new dose, the patient falls asleep. The nurse interprets this as which of the following?
- A. Drug idiosyncrasy
- B. Cumulative drug effect
- C. Drug tolerance
- D. Toxic reactions
Correct Answer: C
Rationale: The patient has developed drug tolerance and has to be administered an increased dosage of the drug to achieve the desired effect. Cumulative drug effect occurs when the body is unable to metabolize and excrete one (normal) dose of a drug before the next dose is given. Drug idiosyncrasy is a term used to describe any unusual or abnormal reaction to a drug. Toxic reactions are caused when blood concentration levels exceed the therapeutic levels of a drug.
A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:
- A. Coumadin, which may lead to bleeding problems
- B. Coumarin, which can cause liver and kidney damage
- C. Cinnamic aldehyde, which is toxic to the kidney
- D. Cinnamate eugenol, which is toxic to the liver
Correct Answer: B
Rationale: Cassia cinnamon contains coumarin, which can be hepatotoxic and nephrotoxic in high doses.