Nokea
You are going to prescribe a drug and the electronic health record (EHR) alerts you that there is a potential drug-drug interaction. The alert is generated by:
- A. The Food and Drug Administration MedWatch system
- B. TOXNET, the National Institutes of Health alert system
- C. The EHR clinical decision support system
- D. Lexicomp, a commercial medication alert system
Correct Answer: C
Rationale: EHR clinical decision support systems generate real-time drug interaction alerts.
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When a primary health care provider phones in a medication order for a client, the nurse should do which of the following? (Select one that does not apply.)
- A. Write down the order.
- B. Record the order as soon as the MAR is retrieved.
- C. Repeat back the information exactly as written.
- D. Clarify any unclear information.
Correct Answer: B
Rationale: If a verbal order is given over the telephone, the nurse writes down the order immediately, repeats back the information exactly as written, and then asks for a verbal confirmation that it is correct. Any order that is unclear should be questioned and clarified.
A 60-year-old man with Type 2 diabetes mellitus is treated with pioglitazone. Which of the following phrases summarizes best this drug's main mechanism of action?
- A. Blocks intestinal carbohydrate absorption
- B. Causes glycosuria (increased renal glucose excretion)
- C. Increases hepatic gluconeogenesis
- D. Increases target tissue sensitivity to insulin
Correct Answer: D
Rationale: Pioglitazone enhances insulin sensitivity in target tissues like muscle and fat via PPAR-gamma activation.
A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy Category B drug. What would the nurse inform the patient?
- A. Adequate studies in pregnant women have demonstrated there is no risk to the fetus.
- B. Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women.
- C. Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant women.
- D. There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks.
Correct Answer: B
Rationale: Category B indicates that animal studies have not demonstrated a risk to the fetus. However, there have not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of pregnancy and no evidence of risk in later trimesters. Category A indicates that adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters. Category C indicates that animal studies have shown an adverse effect on the fetus, but no adequate studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the use of the drugs in pregnant women may outweigh potential risks.
Which of the following is natural glucocorticoid:
- A. Cortisol
- B. Prednisolon
- C. Dexamethasone
- D. Triamcinolone
Correct Answer: A
Rationale: Cortisol is the primary natural glucocorticoid produced by the adrenal glands, unlike the others which are synthetic.
Zero order kinetics are seen in all except
- A. Salicylate
- B. Atenolol
- C. Barbiturates
- D. Ethanol
Correct Answer: C
Rationale: Barbiturates typically follow first-order kinetics; others exhibit zero-order at high doses.