Nokea
Which route of drug administration is most likely to lead to first pass effect?
- A. Sublingual
- B. Oral
- C. Intravenous
- D. Intramuscular
Correct Answer: B
Rationale: Oral administration subjects drugs to the first-pass effect, where they are metabolized by the liver via the portal vein before reaching systemic circulation, reducing bioavailability.
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This graph shows the concentration-dependent effects of norepinephrine on arterial blood pressure, both alone, and in the presence of a fixed concentration of Drug X. Which type of antagonist is Drug X?
- A. Silent
- B. Non-competitive
- C. Competitive
- D. Chemical
Correct Answer: B
Rationale: A non-competitive antagonist reduces the maximal response without shifting the potency (EC50), as indicated by the answer key, likely showing a decreased maximum on the graph.
The following drug may be used in the management of acromegaly:
- A. Leuprolide
- B. Octreotide
- C. Cosyntropin
- D. Desmopressin
Correct Answer: B
Rationale: Octreotide, a somatostatin analog, inhibits growth hormone in acromegaly.
A nurse is preparing a prescribed dose of rabeprazole for a client with gastric ulcers. The nursing drug guide does not list treatment of gastric ulcers among the recognized indications for this drug. What should the nurse do?
- A. Administer the drug as ordered
- B. Clarify with the prescriber concerning the ordered drug
- C. Document this potential error in the client's health record
- D. Ask the client whether he or she has taken this drug before
Correct Answer: B
Rationale: Rabeprazole is typically for GERD, not gastric ulcers per standard indications; clarifying with the prescriber ensures safety and appropriateness.
A nurse is caring for a client who has Atrial Fibrillation and a new prescription for Dabigatran to prevent development of Thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of Dabigatran?
- A. Vitamin k1
- B. Protamine
- C. Omeprazole
- D. Probenecid
Correct Answer: C
Rationale: Omeprazole reduces dabigatran's GI bleeding risk, a common side effect.
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.