Nokea
You are caring for a patient who takes several drugs. You know that those patients most likely to have adverse drug reactions are who?
- A. Patients with coronary artery disease
- B. Non-compliant patients
- C. Patients who are on the recommended dose
- D. Very young and very old patients
Correct Answer: D
Rationale: Very young and old patients have immature or declining organ function, increasing adverse reaction risk.
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Patients with pernicious anemia require treatment with:
- A. Iron
- B. Folic acid
- C. Epogen alpha
- D. Vitamin B12
Correct Answer: D
Rationale: Pernicious anemia requires vitamin B12 due to absorption deficiency; folate masks it without correcting neuropathy.
The tricyclic antidepressants should be prescribed cautiously in patients with:
- A. Eczema
- B. Asthma
- C. Diabetes
- D. Heart disease
Correct Answer: D
Rationale: TCAs can cause cardiac arrhythmias, necessitating caution in heart disease.
Low doses of aspirin prolong bleeding time by selectively inhibiting synthesis of the following mediator in the platelets:
- A. Thromboxane Aâ‚‚
- B. 5-Hydroxytryptamine
- C. Platelet activating factor
- D. Prostacyclin
Correct Answer: A
Rationale: Low-dose aspirin irreversibly inhibits COX-1 in platelets, reducing thromboxane Aâ‚‚ production, which promotes platelet aggregation, thus prolonging bleeding time.
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.
Mary has a two-tiered prescription benefit plan, which means:
- A. She can receive differing levels of care based on whether she chooses an 'in-plan' provider or not.
- B. She is eligible for the new Medicare Part D 'donut hole' reduction of costs program.
- C. She pays a higher copay for brand-name drugs than for generic drugs.
- D. She must always choose to be treated with generic drugs first.
Correct Answer: C
Rationale: A two-tiered plan typically involves higher copays for brand-name drugs.