Adaptive Quiz Questions Part 2
Which herbal supplements would interact with warfarin?
Garlic, ginger root, and ginkgoA patient is taking orlistat and levothyroxine. Which statement by the patient indicates the need for clarification?
Food rich in iron
tomatoes, orange juice and strawberries
Trade name for coumadin
warfarin
What factors would the nurse recognize as having a possible effect on medication response?
Body composition level of education genetic influences use of alternative therapies patient compliance with therapy
When teaching a pregnant pt. about the effects of medication on the fetus, the nurse should recognize that the greatest harm from maternally ingested medications occurs during which time period?
First Trimester
What taking garlic do for a patient who prescribed aspirin IM?
Increase the risk of bleeding
The nurse administers meperidine and promethazine. Which response does the nurse anticipate because of their potentiating effect? Explain the reasoning behind your answer
Increased pain relief Bc both are pain relief drugs and potentiating effects means that they intensify each other so the pain relief will just be increased with both of them working together in the body
What vitamin prevents Wernicke-Korsakoff Syndrome?
Thiamine
A pt. who takes oral contraceptives is prescribed phenobarbital. Both drugs are known to induce cytochrome P450 (CYP) isoenzymes. What pt. teaching should the nurse provide? Explain why.
"Plan to use another form of birth control while taking phenobarbital" - bc phenobarbital induces CYP isoenzymes that act on oral conceptives; therefore, it will increase the metabolism of these drugs, resulting in decreased blood levels which you dont want to happen
Class I MHC (major histocompatibility complex)molecules
"present" antigens to cytotoxic T cells
A nurse is teaching about preventing infections. What cells should the nurse include when describing the cell-mediated immunity?
- CD4, Cytolytic T lymphocytes, antigen-presenting cells
Deitary foods for each vitamin - Vitamin B - Vitamin A, K, and D - Vitamin K - Vitamin D and E
- Whole grain products - diary products; cheese - spinach - fish
The nurse is teaching a group of coworkers the benefits of resveratrol. Which characteristics will the nurse identify as attributable to resveratrol?
- antiplatelet actions - antioxidant activity - increased insulin sensitivity
What factors may contribute to unintentional nonadherence?
- forgetfulness - inability to pay for medications - failure to comprehend instructions
Use of following herbs: - ginger root - glucosamine - ginkgo biloba - cranberry juice
- motions sickness, nausea and vertigo - joint pain - increase pain-free walking distance in pts. with peripheral arterial disease - prevention of urinary tract infections
After a patient's routine physical, the nurse is reviewing the patient's record and sees that the patient takes acetaminophen (Tylenol) for chronic shoulder pain and has a history of depression and gout. The nurse notes the patient's aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels are raised. Which drug does the nurse expect to also find in the patient's chart? 1) Aspirin 2) Ibuprofen 3) Duloxetine 4) Amoxicillin-clavulanic acid
3. Duloxetine
After reading an article on immunity, a student asks the nurse how cytolytic T lymphocytes kill antigens. What is the nurse's best response? 1) "Apoptosis occurs." 2) "Interferon activates CD4 cells." 3) "Perforin forms holes in the target cell membrane." 4) "Cytokines draw macrophages and other immune cells to the site of infection."
3. Perforin forms holes in the target cell membrane
Which vitamins are considered fat-soluble vitamins?
A,D,E, and K
What nursing action results in the most common human cause of fatal medication errors?
Administering a drug IV instead of IM
Every child should receive two vaccinations. At what age range should the first one be given?
Ages 12 to 15 months
Every child should receive two vaccinations. At what age range should the second one be given?
Ages 4 to 6 years
The patient reports taking kava. The nurse recalls that kava is used for which problems?
Anxiety and insomnia
Generic name for vitamin C
Ascorbic acid
A nurse is teaching a patient about antibodies. Which cell will the nurse identify as the cell that makes the antibodies in humoral immunity?
B cells (B lymphocytes)
Weight loss therapy is indicated for what type of people
BMI 26 and two risk factors BMI 35 with no risk factors wasit circumference of 40 in and two risk factors
Before giving the hepatitis B vaccine (HepB), it is most important for the nurse to ask whether the patient is allergic to what substance
Bakers yeast
Which vitamins are considered water soluble vitamins?
C and B complex
Which treatment modality is central to any weight-loss regimen?
Caloric restriction
Adverse effects of phentermine
Chest pain
Alternative vs. Classical pathway of complement system
Classical pathway is activated by antibodies" classical is not
A patient who has hypertension is prescribed diltiazem hydrochloride 240 mg daily upon discharge. The nurse notes that the patient has a recently filled prescription for diltiazem hydrochloride 120-mg capsules at home. What action will the nurse take?
Discuss this with the provider and request an order to give the medication that the pt. already has in the correct dose In this case, notify the provider and discuss a written order for two 120 mg capsules of diltiazem hydrochloride
The sale of which herbal medication was banned by the Food and Drug Administration (FDA) in April 2004 because of its cardiovascular side effects?
Ephedra
When assessing for drug effects in the older adult, which phase of pharmacokinetics is the greatest concern?
Excretion
Kava is associated with which condition history?
Hepatits bc of liver toxicity
The patient is taking black cohosh (Cimicifuga racemosa) for relief of menopausal symptoms. The nurse should caution her about adverse interactive effects with which conventional medication? Why?
Insulin - bc black cohosh may potentiate the hypoglycemic effect of insulin and oral hypogylcemics
Which substance serves as the stimulus for macrophage activation in delayed-type hypersensitivity reactions?
Interferon gamma
What schedule and pregnancy category is lorcaserin in?
It is classified as a schedule IV controlled substance and category X for pregnancy risk factor
What can defatted flaxseed or the herbal use of flaxseed do?
May increase trigylceride levels
What is meant by potentiating effects?
Meaning that one drug intensifies the effect of the other
The school nurse is teaching high school students about the immune system. Which characteristic of the immune system produces faster and prolonged symptoms after initial exposure to an antigen?
Memory cells (memory)
A nurse is describing mediator molecules released by any immune system cell. Which specific term does the nurse use to identify a mediator molecule released by a phagocyte?
Monokines "M" for Mediator
A patient has a deficiency of riboflavin. Which area should the nurse assess first when monitoring for improvement of this condition?
Mouth
A nurse administerz pyridoxine (B6) to a pt. with TB. The nuse explains to the pt. that te drug prevents what condition?
Peripheral Neuritis
A patient who takes orlistat is experiencing uncontrollable diarrhea that is fatty and foul smelling. The nurse should instruct the patient to take which supplement?
Psyllium
What can drugs that induce PGP or P-glycoproteins cause?
Reduced absorption of other drugs
What may ginger do for someone with rheumatoid arthritis?
Relieve the stiffness that comes with itWhat
What type of drug is Lorcaserin
Serotegenic drug
A patient who has pellagra is taking niacin. Which outcome would be most appropriate for a nurse to establish with the patient?
Smooth, intact skin in sun-exposed areas
What is the purpose of MedGuide?
To educate patients about how to minimize harm from potentially dangerous drugs
What are two characteristics if probiotics?
They can cause flatulence They are composed of bacteria and yeast
Topical enchinacea treatment
Used to treat wounds, burns, eczema, psoriasis, and herpes simplex
What vitamin prevents Keratomalacia and Xerophthalmia?
Vitamin A
Which vitamins are most likely to lead to toxic levels (hypervitaminosis) when administered in megadoses?
Vitamin A, D and K
Which fat-soluble vitamin is synthesized by the bacterial flora in the gastrointestinal tract?
Vitamin K
Which vitamin interferes with levodopa (a drug for Parkinsons disease)?
Vitamine B6 (Pyridoxine)
Function of interferon alpha
activate macrophages, cytoltic cells, and natural killer cells
What drugs should not be taken with st. johns wort?
amphetamines, cocaine, and many antidepressants such as MAOI's selective serotonin reuptake inhibitors, certain tricyclic agents (ex. amitriptyline and clomipramine) and duloxetine, nefazodone, and venlafaxine
Vitamin B6 deficiency
characterized as neuritis, convulsions, seborrheic dermatitis, anemia and confusion
A patient reports taking garlic to reduce cholesterol. The nurse recalls that which form of garlic is most effective?
enteric coated garlic
What are the major actors in immune response (cells)
macrophages, lymphocytes ad dendritic cells
What are some common side effects of glucosamine?
nausea and heartburn
Class II MHC (major histocompatibility complex) molecules
other immune cells to the site of infection." "present" antigen to helper T cells
While reviewing a patient's laboratory results, the nurse identifies an increase in eosinophils. The patient most likely has which condition?
parasitic worms
Like other fiber products, what do flaxseeds decrease?
plasma level of total cholesterol and
What can high doses of vitamin E cause?
platelet aggregation; increasing risk of bleeding
The nurse administers a drug that induces P-glycoprotein (PGP). What outcome should the nurse expect when this drug is given with other drugs?
reduced absorption of other drugs
When should diethylpropion be taken?
should be taken at bedtime
Define Opsonization
the coating of bacteria with antibodies