Nokea
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.
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Which of the following is not a dose related reaction:
- A. Myocardial Irritation of Quinidine
- B. Hypoglycemia of tolbutamide
- C. Digitalis induced arrythmia
- D. Drug fever of sulpha
Correct Answer: D
Rationale: Drug fever from sulfa is an idiosyncratic/hypersensitivity reaction, not dose-related.
You are assigned to infuse 300 mL of a solution over 2 hours with a drop factor of 15 gtt/mL. What is the flow rate in drops per minute?
- A. 25 gtt/min
- B. 37.5 gtt/min
- C. 45 gtt/min
- D. 75 gtt/min
Correct Answer: B
Rationale: Flow rate = (300 mL 15 gtt/mL) ÷ (2 60) = 4,500 ÷ 120 = 37.5 gtt/min, exactly matching option B.
The nurse is teaching a nursing student about the antifungal drug amphotericin B. Which statement by the student indicates a need for further teaching?
- A. Amphotericin B may be given intravenously or by mouth
- B. Patients who take this drug should have potassium and magnesium levels assessed
- C. Patients with renal disease should not take amphotericin B
- D. This drug is used for severe systemic infections
Correct Answer: A
Rationale: Amphotericin B is IV-only due to poor oral absorption; electrolyte monitoring and systemic use are correct. Amphotericin B is not absorbed from the gastrointestinal tract, so is not given by mouth.
Your patient calls for an appointment before going on vacation. Which medication should you ensure he has an adequate supply of before leaving to avoid life-threatening complications?
- A. Carvedilol
- B. Donepezil
- C. Bethanechol
- D. Tacrine
Correct Answer: A
Rationale: Abrupt carvedilol withdrawal can cause life-threatening rebound hypertension or ischemia.
A nurse is preparing to administer Propranolol to a client who has a dysrhythmia. Which of the following actions should the nurse plan to take?
- A. Hold propranolol for an apical pulse greater than 100/min.
- B. Administer propranolol to increase the client's blood pressure.
- C. Assist the client when she sits up or stands after taking this medication.
- D. Check for hypokalemia frequently due to the risk for propranolol toxicity.
Correct Answer: C
Rationale: Propranolol can cause orthostatic hypotension; assisting with position changes prevents falls.