RN exams pharmacology practice questions set 15

Correct answer:

The correct answer is B: Non-competitive antagonist. This is because a non-competitive antagonist binds irreversibly to a different site on the receptor compared to the agonist (norepinephrine in this case) and prevents its activation, leading to a decrease in response. In the graph, the presence of Drug X shifts the concentration-response curve of norepinephrine downward without affecting the maximum response, indicating non-competitive antagonism. A: Silent antagonists do not affect the agonist's binding or activity on the receptor. C: Competitive antagonists compete with the agonist for the same binding site on the receptor, affecting potency but not the maximum response. D: Chemical antagonist is a broad term for any antagonist that binds to the agonist or receptor to prevent activation but does not specifically describe the mechanism like non-competitive antagonism does.

Correct answer:

The correct answer is B: Fludrocortisone excess. In Addison's disease, there is adrenal insufficiency leading to low levels of cortisol and aldosterone. Fludrocortisone is a synthetic mineralocorticoid used to replace aldosterone in the treatment of Addison's disease. Excess fludrocortisone can cause retention of sodium and water, leading to hypertension, hypokalemia, weakness, and paresthesias. Constipation can also occur due to altered electrolyte balance. A: Cortisol-induced hyperglycemia is not the best explanation for the patient's symptoms as hyperglycemia is not a prominent feature of Addison's disease. C: Inadequate therapy of adrenal insufficiency would not cause the specific symptoms mentioned. D: Cortisol-induced myopathy is not the primary cause of weakness and paresthesias in Addison's disease; aldosterone deficiency leading to electrolyte imbalance is more relevant.

Correct answer:

The correct answer is A: A thiazide diuretic. Thiazide diuretics are recommended as the initial medication for managing hypertension in patients without compelling indications. They are effective in lowering blood pressure by reducing the volume of circulating blood. In this case, the patient's blood pressure readings are consistently elevated, indicating the need for pharmacological management. Thiazide diuretics have been shown to reduce cardiovascular events and mortality in hypertensive patients. Loop diuretics and Spironolactone (Choice B) are not first-line treatments for hypertension and are typically used in specific cases like heart failure. Beta blockers (Choice C) are not the preferred initial treatment for hypertension in the absence of other compelling indications. Thus, the most appropriate choice for managing this patient's hypertension would be a thiazide diuretic.

Correct answer:

The correct answer is A: A thiazide diuretic. Thiazide diuretics are recommended as the initial medication for managing hypertension in patients without compelling indications. They are effective in lowering blood pressure by reducing the volume of circulating blood. In this case, the patient's blood pressure readings are consistently elevated, indicating the need for pharmacological management. Thiazide diuretics have been shown to reduce cardiovascular events and mortality in hypertensive patients. Loop diuretics and Spironolactone (Choice B) are not first-line treatments for hypertension and are typically used in specific cases like heart failure. Beta blockers (Choice C) are not the preferred initial treatment for hypertension in the absence of other compelling indications. Thus, the most appropriate choice for managing this patient's hypertension would be a thiazide diuretic.

Correct answer:

Rationale for Correct Answer (A): Most AIDS patients with multiple opportunistic infections die due to a weakened immune system impairing response to therapy. When the immune system is compromised, the body struggles to fight off infections effectively, even with treatment. This results in the infections becoming more severe and ultimately leading to death. Summary of Other Choices: B: Weakened immune system impairs resistance to infection - While this is true, it doesn’t directly address the cause of death in AIDS patients with multiple infections. C: Infection cannot be treated effectively - This is not entirely accurate as infections can be treated, but the weakened immune system hinders the response to treatment. Overall, Choice A is the most accurate as it directly links the weakened immune system to the inability to respond effectively to therapy, leading to fatal outcomes.

Correct answer:

Correct Answer: B: Calcium should be avoided Rationale: 1. Calcium is an essential mineral for bone health, especially important for individuals with limited mobility like Richard. 2. Avoiding calcium can lead to bone weakening and increase the risk of fractures. 3. Nursing care plans should include adequate calcium intake to support bone health. 4. Therefore, avoiding calcium is not a recommended nutritional consideration. Summary of Incorrect Choices: A: The diet should be semisolid to facilitate the passage of food - This is important for individuals with swallowing difficulties. C: The patient should be sitting in an upright position during feeding - This aids in proper digestion and reduces the risk of aspiration. D: Thick fluids should be encouraged to provide additional calories - Thick fluids may increase the risk of aspiration in patients with neurological conditions.

Correct answer:

The correct answer is B: Inhibiting HMG-CoA reductase in the liver. Atorvastatin is a statin drug that works by inhibiting the enzyme HMG-CoA reductase, which is involved in the production of cholesterol in the liver. By inhibiting this enzyme, atorvastatin reduces the synthesis of cholesterol in the liver, leading to lower levels of LDL cholesterol in the bloodstream. A: Inhibiting the reabsorption of cholesterol in the intestines - This is incorrect because atorvastatin primarily works in the liver, not in the intestines. C: Increasing HDL cholesterol levels - Atorvastatin is more effective at lowering LDL cholesterol levels rather than increasing HDL cholesterol levels. D: Increasing the excretion of cholesterol in the bile - Atorvastatin does not directly increase the excretion of cholesterol in the bile, it primarily acts in the liver to reduce cholesterol production.

Correct answer:

Step 1: Diuretics can cause orthostatic hypotension, leading to a drop in blood pressure upon standing. Step 2: Orthostatic hypotension increases the risk of falling and injury, especially in older adults. Step 3: By instructing the patient to take extra precautions when standing up, the nurse helps prevent falls and injuries. Step 4: This teaching point is crucial for promoting the patient's safety and independence at home. Summary: Choice A is incorrect because the timing of diuretic intake with meals is not as critical as preventing falls. Choice B is incorrect as skipping doses can lead to uncontrolled hypertension. Choice C is incorrect because stopping the medication abruptly can have negative consequences and potassium supplements may not be necessary. Choice D is correct as it addresses the potential side effect of orthostatic hypotension and emphasizes safety measures.

Correct answer:

The correct answer is A: Inhibiting the reabsorption of glucose in the kidneys. Canagliflozin is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that works by blocking the reabsorption of glucose in the kidneys, leading to increased urinary glucose excretion and lowering blood glucose levels. This mechanism of action is unique to SGLT2 inhibitors and helps improve glycemic control in patients with type 2 diabetes. Choice B is incorrect because canagliflozin does not stimulate the pancreas to release more insulin. Choice C is incorrect as canagliflozin does not increase the release of glucagon from the pancreas. Choice D is incorrect because canagliflozin does not directly improve insulin sensitivity in peripheral tissues. The key mechanism of action of canagliflozin lies in its specific inhibition of glucose reabsorption in the kidneys, making choice A the correct answer.

Correct answer:

The correct answer is B: Diphenhydramine. Diphenhydramine is a first-generation antihistamine that can cause anticholinergic toxicity in overdose. The symptoms described in the question such as high body temperature, dry skin, dilated pupils, and agitation are consistent with anticholinergic poisoning. Diphenhydramine also has sedative effects which can lead to seizures in high doses. A: Ibuprofen is a nonsteroidal anti-inflammatory drug and overdose typically presents with symptoms like gastrointestinal upset and kidney injury, not the symptoms described in the question. C: Phenylephrine is a decongestant that can cause hypertension and tachycardia in overdose, not the symptoms described in the question. D: Celecoxib is a selective COX-2 inhibitor used as an NSAID and overdose usually presents with gastrointestinal symptoms, not the symptoms described in the question.