Nursing Elites

1. Which drug undergoes extensive first-pass hepatic metabolism?

• A. Heparin
• B. Insulin
• C. Propranolol
• D. Nitroglycerin

Correct answer: C

Rationale: Propranolol undergoes extensive first-pass hepatic metabolism in the liver. When administered orally, propranolol is extensively metabolized by the liver before reaching systemic circulation, leading to reduced bioavailability. This process is known as first-pass hepatic metabolism, which significantly affects the drug's effectiveness and necessitates higher oral doses compared to other routes of administration. Heparin (Choice A) is not metabolized by the liver but excreted unchanged by the kidneys. Insulin (Choice B) is a peptide hormone that is not subject to significant first-pass metabolism. Nitroglycerin (Choice D) is primarily metabolized in the blood and tissues, bypassing significant first-pass metabolism in the liver.

2. Which of the following is a potassium-sparing diuretic?

• A. Furosemide
• B. Spironolactone
• C. Hydrochlorothiazide
• D. Bumetanide

Correct answer: B

Rationale: Spironolactone is classified as a potassium-sparing diuretic. It works by antagonizing the aldosterone receptor, leading to potassium retention and sodium excretion. This mechanism makes it a suitable choice for conditions where potassium retention is desired, such as in patients with heart failure or liver cirrhosis. Choices A, C, and D are not potassium-sparing diuretics. Furosemide, hydrochlorothiazide, and bumetanide are loop diuretics and thiazide diuretics, respectively, which promote the excretion of potassium.

3. A client has a new prescription for Beclomethasone. Which of the following instructions should the nurse include?

• A. Rinse your mouth after each use of this medication.
• B. Limit fluid intake while taking this medication.
• C. Increase your intake of vitamin B12 while taking this medication.
• D. You can take the medication as needed.

Correct answer: A

Rationale: The correct instruction for a client prescribed Beclomethasone is to rinse the mouth after each use to reduce the risk of oral fungal infection. Beclomethasone is a corticosteroid inhaler that can increase the risk of oral thrush, so rinsing the mouth helps minimize this side effect. Choice B is incorrect because there is no need to limit fluid intake while taking Beclomethasone. Choice C is incorrect as there is no specific need to increase vitamin B12 intake with this medication. Choice D is incorrect because Beclomethasone should be taken as prescribed, not as needed.

4. When educating a client who has a new prescription for Levothyroxine to treat hypothyroidism, which of the following instructions should be included?

• A. Take the medication first thing in the morning before eating.
• B. Take the medication at bedtime to avoid drowsiness.
• C. Take the medication with food to prevent nausea.
• D. Take the medication with a glass of milk.

Correct answer: A

Rationale: Levothyroxine should be taken first thing in the morning before eating to ensure optimal absorption. Taking it on an empty stomach helps prevent interactions with food or other medications that may decrease its effectiveness. It is important to follow this timing recommendation to maintain consistent thyroid hormone levels in the body. Choice B is incorrect as taking Levothyroxine at bedtime may lead to inconsistent absorption and affect its efficacy. Choice C is incorrect because taking Levothyroxine with food can interfere with its absorption. Choice D is incorrect as Levothyroxine should be taken with a full glass of water, not milk, to aid in proper absorption.

5. A client has a new prescription for Digoxin. Which of the following instructions should the nurse include?

• A. Increase your intake of bran fiber.
• B. Monitor your heart rate before taking the medication.
• C. Take the medication with antacids.
• D. Avoid drinking orange juice.

Correct answer: B

Rationale: When a client is prescribed Digoxin, it is essential to monitor their heart rate before each dose. Changes such as a heart rate below 60 bpm should be reported to the healthcare provider promptly. This is crucial because Digoxin can affect heart rhythm, and monitoring the heart rate helps in identifying any potential issues early on.

Similar Questions