Cardiology
Hemodynamics: A drug that is classified as a positive inotrope (e.g., Digoxin) will have which primary effect on the heart?
Increase the force of ventricular contraction (contractility)
Penicillin achieves selective toxicity by targeting which unique structure in bacteria?
Disruption of the bacterial cell wall
What is the primary reason that insulin cannot be administered orally
Gastric enzymes destroy insulin, rendering it inactive.
The cardinal symptoms of PD are caused by which neurotransmitter imbalance in the striatum?
Too little Dopamine and too much Acetylcholine (ACh)
A patient receiving an FGA for several years develops involuntary, twisting, and worm-like movements of the tongue and face. The nurse reports this potentially irreversible movement disorder as:
Tardive Dyskinesia (TD).
Acute Coronary Syndrome: A patient with acute chest pain is prescribed sublingual Nitroglycerin. The nurse understands the protocol requires the patient to take how many doses, at what interval, before calling 911 (or proceeding to IV therapy if in the hospital)?
A maximum of 3 doses, 5 minutes apart.
A patient receiving Amphotericin B is at high risk for nephrotoxicity. What key nursing intervention is used to help minimize this adverse effect
Administering 1L of 0.9% Normal Saline (NS) prior to the infusion
A conscious patient with an intact gag reflex has a blood glucose of 58 mg/dL. What is the best initial action by the nurse?
Administer an oral carbohydrate (e.g., a glass of juice) followed by a protein food.
A patient asks why they must take both Levodopa and Carbidopa (Sinemet). The nurse explains that Carbidopa's primary role is to:
Inhibit Levodopa breakdown in the periphery, allowing more to reach the brain
A nurse is reviewing a patient's Lithium maintenance lab results. The nurse knows that the therapeutic range for Lithium is:
0.5 to 1.0 mEq/L.
HMG-CoA Reductase Inhibitors (Statins): The nurse is educating a patient starting Simvastatin for hypercholesterolemia. The nurse must instruct the patient to immediately report which two key signs/symptoms of serious adverse effects?
Unexplained muscle aches/tenderness and dark-colored urine.
The nurse is teaching a patient about a newly prescribed Tetracycline antibiotic. The patient must be instructed to avoid taking the medication concurrently with which product?
Dairy products (milk, cheese, yogurt).
The nurse knows that Metformin is contraindicated in patients with acute or chronic renal disease due to the increased risk of which serious, potentially fatal, adverse effect?
Lactic Acidosis
When administering Valproic Acid (Depakote), the nurse must monitor for signs and symptoms of which two major organ toxicities?
Hepatotoxicity and Pancreatitis.
The nurse must educate a patient on Lithium about the potential for toxicity when combining it with which common over-the-counter (OTC) drug?
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as Ibuprofen.
Beta Blockers: A patient is taking Metoprolol (Lopressor) for hypertension and heart failure. The nurse knows that the therapeutic effects of this drug are primarily related to which actions?
Negative chronotropic and negative inotropic effects.
The primary disadvantage associated with the use of a broad-spectrum antibiotic is:
It promotes the greatest development of antimicrobial resistance
Which type of insulin is considered a short-duration, rapid-acting agent that is administered just before a meal to control post-prandial glucose?
Insulin Lispro (Humalog)
Adrenergic Agonists: A patient with asthma is treated with a drug that selectively stimulates Beta-2 adrenergic receptors. Which therapeutic effect is the nurse expecting?
Relaxation of smooth muscle in the lungs, causing bronchodilation.
A child starting on Methylphenidate (Ritalin) should be instructed to take the last dose of the day at what time?
Early in the day (e.g., before 4:00 PM) to minimize insomnia
Which dyslipidemia medication class is primarily used to most effectively decrease serum triglycerides (VLDL)?
Fibrates (e.g., Gemfibrozil)
Azole antifungals (e.g., Itraconazole, Fluconazole) have a key drug-drug interaction profile. They are known to have which effect on other medications?
They inhibit CYP450 enzymes, which increases the levels of many other medications.
A patient is starting on the SGLT2 inhibitor Canagliflozin (Invokana). The nurse should prioritize monitoring the patient for which common adverse effect?
Genital fungal infections and urinary tract infections (UTIs).
Atropine is the prototype anticholinergic drug. The nurse understands that common adverse effects of anticholinergic agents include
Tachycardia, urinary retention, and dry mouth.
The primary advantage of a Second-Generation Antipsychotic (SGA) over an FGA is:
A significantly lower risk of movement disorders/Extrapyramidal Symptoms (EPS)