Minerals Visovsky: Introduction to Clinical Pharmacology, 9th Edition

1. You are teaching a patient about taking over-the-counter (OTC) drugs. Which important safety information should you include in your teaching plan? a. "OTC drugs will only maintain their potency months after the expiration date." b. "OTC drugs often interact with other drugs, and with food or alcohol" c. "Be sure to take all the pills in the bottle." d. "Adjust the dosage to your specific needs." ANS: B OTC drugs often interact with other drugs, and with food or alcohol, or they might affect other existing health problems the patient has. Ask a pharmacist or the healthcare provider if you are unsure. Also, the health care professional must be aware of all over-the-counter drugs being taken because of the dangers of interaction. p. 346 2. A patient informs you that she is buying over-the-counter (OTC) drugs online from another country because they are cheaper. What is your best response? a. "I agree with you, it is important to save money on expensive drugs when you can." b. "There is no difference between generic OTC drugs from different countries." c. "Avoid buying OTC drugs online, as they may be counterfeit or dangerous." d. "Only buy OTC drugs online if your insurance company covers them." ANS: C Patients should avoid buying these products online, outside of well-known Internet insurance company sites, because many OTC preparations sold through the Internet are counterfeit products and may be dangerous. REF: p. 348 00:13 01:08 3. What information is important to include when teaching parents about giving over-the-counter (OTC) drugs to children? a. Do not give drugs containing alcohol to children. b. OTC drugs are safe for children younger than 2 years of age. c. When giving OTC drugs to a child, always give one-half of the adult dose. d. Refrain from using a child-resistant cap in the event the drug must be given quickly. ANS: A One of the most important considerations in reading OTC product labels is to notice the hidden chemicals (used for various purposes) in the products. Drugs containing alcohol (such as some cough preparations) should not be given to children. REF: p. 348 4. Which of the following drug types is not regulated by the Food and Drug Administration? a. Opioids b. Vitamins c. Hormones d. Herbal supplements ANS: D The FDA does not regulate herbal supplements but protects consumers from misleading health claims by the supplement industry. REF: p. 349 5. During your assessment of a clinic patient, the patient asks you if using expired over-the-counter (OTC) drugs would cause harm. What is your best answer? a. "These drugs are safer than prescription drugs, so using expired OTC drugs is harmless." b. "Disposing of expired drugs is only necessary if you have several drug allergies." c. "You should always safely dispose all expired or discolored drugs." d. "The chemical preservatives in OTC drugs prevent drug expiration." ANS: C You should always tell patients to safely dispose of old, discolored, or expired drugs or any drug that has lost its label instructions. Your pharmacist can tell you about the ways to safely dispose of drugs. REF: p. 348 6. A patient with depression tells you she is using St. John's wort to treat her symptoms because she would rather use a natural product, as she already takes many prescription drugs. What is your best response? a. "St. John's wort has been proven effective in treating mild to moderate depression." b. "You may take St. John's wort with your other prescription drugs without concern." c. "Avoid taking St. John's wort because it interferes with many prescription drugs." d. "Avoid using St. John's wort unless you have weekly blood levels drawn." ANS: C St. John's wort may improve mild to moderate depression but has potentially dangerous interactions with many prescription drugs. REF: p. 350 7. Which statement about multivitamins is true? a. Most people will take multivitamins without consulting a healthcare professional. b. Many multivitamins are used with prescription drugs to prevent disease. c. Multivitamins are drug preparations that do not expire. d. Multivitamins do not pose a risk for adverse effects. ANS: A People take vitamins to maintain health or to correct specific nutritional deficiencies. Most people decided to take vitamins on their own without the advice of a health care professional. REF: p. 350 8. A patient with a severe upper respiratory infection tells you she is taking mega-doses of vitamin C to help her get rid of the infection quicker. What is your best response? a. "Taking high doses of vitamin C is recommended for this purpose." b. "Taking high doses of vitamin C is not effective because it is excreted quickly." c. "Vitamin C is a fat-soluble vitamin, and high doses can be dangerous'" d. "Vitamin C is only useful in treating malabsorption syndromes." ANS: B Vitamin C is a water-soluble vitamin that is quickly excreted and thus mega-doses of this vitamin produce no additional benefit. REF: p. 354 9. A patient in the clinic asks you if she should purchase an expensive brand-name multivitamin because cheaper vitamins may not be as good. What is your best response to this patient? a. "All over-the-counter multivitamin preparations are the same." b. "There is a price-quality relationship to the vitamin product you buy." c. "The cost of the vitamin preparation is not an indication of effectiveness." d. "The cost of multivitamins is related to the bioavailability of the vitamins in the formula." ANS: C The costs for some products are high because of the claims made about their effectiveness, but few of the manufacturer claims can be substantiated by evidence. REF: p. 350 10. A newly pregnant patient is taking oral vitamin A to encourage embryo growth. What would you include in your teaching plan for this patient? a. "Vitamin A is a water-soluble vitamin, so it is safe for the fetus." b. "Take only the amount prescribed; high doses can cause birth defects." c. "Taking vitamin A during the first 12 weeks of pregnancy is recommended." d. "Only take vitamin A in the last trimester of pregnancy to encourage fetal growth." ANS: B Excess vitamin A ingestion during pregnancy can cause birth defects of the central nervous system. REF: p. 351 11. A patient has been admitted for suspected vitamin A overdose. What symptoms would you expect the patient to exhibit? a. Diarrhea and fever b. Constipation and changes in taste c. Ecchymosis of the lower extremities d. Yellowing of the skin on the nose and ears ANS: D An early indication of vitamin A overdose is anorexia, abdominal pain, malaise, and yellowing of the skin, especially on the nose and ears. REF: p. 352 12. You are getting ready to give an intravenous preparation containing vitamin B1 (thiamine) to a patient with alcoholism. What is the rationale for giving thiamine in an IV solution containing glucose? a. Glucose is necessary to assist thiamine in entering the cells. b. Glucose prevents the thiamine from being excreted. c. Glucose prevents precipitation of the IV fluid d. Glucose is needed for thiamine absorption. ANS: C If giving thiamine to an alcoholic or thiamine deficient patient, intravenous glucose should also be given to prevent precipitation or worsening of Wernicke's encephalopathy. REF: p. 352 00:03 01:08 Upgrade to remove ads Only $35.99/year 13. You are teaching a patient with a dietary deficiency of riboflavin about foods that contain riboflavin that should be part of the patient's diet. Which of the following foods would be recommended? a. Enriched flour b. Dairy products c. Whole grains such as barley d. Orange-colored vegetables such as carrots ANS: B Teach patients that common food sources of riboflavin include dairy products, eggs, green leafy vegetables, organ meats, and peanuts. REF: p. 352 14. A patient you are caring for has been started on niacin as part of a regimen to reduce hyperlipidemia. Which unpleasant side effects of niacin should you teach this patient to expect? a. Skin warmth and flushing b. Yellow-tinged skin and sclera c. Beefy-red tongue d. Watery eyes ANS: A Expected side effects of niacin supplementation are skin warmth, flushing, and itching that can be relieved when giving niacin with aspirin. REF: p. 352 15. Which drug category is associated with pyridoxine deficiency? a. Antibiotics b. Beta blockers c. Antilipidemics d. Oral contraceptives ANS: D Oral contraceptives may induce pyridoxine deficiency. REF: p. 352 16. A newly pregnant woman placed on folic acid states she does not want to take any drugs during her pregnancy. What is your best response? a. "Folic acid is crucial to the development of the sex organs of the fetus." b. "Folic acid is crucial to the development of the cardiovascular system." c. "Folic acid is given to prevent neural tube defects of the spinal cord." d. "Folic acid will prevent nausea and vomiting during pregnancy." ANS: C The US Public Health Service has issued an official recommendation that all women of childbearing age in the United States who are pregnant should consume folic acid for reducing their risk of having a pregnancy affected with spina bifida or other neural tube defects. REF: p. 353 17. You are evaluating a patient's understanding of a newly prescribed drug regimen for the prevention of heart disease. Which response made by the patient demonstrates understanding of the drug regimen? a. "I will take folic acid every other day." b. "I will take calcium supplements daily with meals." c. "I will take a daily dose of folic acid and vitamins B6 and B12." d. "I will take a quality multivitamin and additional ferrous sulfate daily." ANS: C Folic acid and vitamins B6 and B12 have been shown to reduce homocysteine levels. Modestly elevated homocysteine levels in the blood are a risk factor for heart disease. REF: p. 353 18. Which patient would be most likely to develop a vitamin B12 deficiency? a. A patient who takes ibuprofen daily for arthritis b. A patient who smokes cigarettes daily c. A patient who is on a vegetarian diet d. A patient with sickle cell anemia ANS: C A patient who is on a strict vegetarian diet may develop vitamin B12 deficiency because vitamin B12 is found only in animal products. REF: p. 353 19. A patient with multiple vitamin deficiencies is prescribed oral vitamin C as part of a vitamin supplementation treatment. Which of the following instructions regarding vitamin C should be given to this patient? a. "Keep vitamin C tablets away from heat and light sources." b. "Only take vitamin C when you are unable to eat citrus fruits." c. "There are no interactions of vitamin C with other drugs you may be taking." d. "Vitamin C is a fat-soluble vitamin primarily used to treat blood clotting disorders." ANS: A Vitamin C is easily destroyed by air, heat, and light. This drug should be kept tightly capped in its own container. REF: p. 354 20. You are caring for a patient who has a family history of cancer. The patient reports taking vitamin E daily for cancer prevention. What is your best response? a. "Recent evidence shows that vitamin E is safe and effective for cancer prevention." b. "You may take vitamin E for cancer prevention as long as it is the prescription form." c. "There is currently no evidence that taking vitamin E will prevent cancer." d. "Vitamin E is only useful in the prevention of heart disease." ANS: C Many suggested uses of vitamin E are controversial and unproved. New evidence suggests that vitamin E supplements do not reduce the risk for cancer or major cardiovascular disease and may even increase the risk of heart failure. REF: p. 355 21. Which drug overdosage would you expect vitamin K to be given as an antidote? a. Warfarin b. Heparin c. Pyridoxine d. Ascorbic acid ANS: A Vitamin K is the antidote for warfarin (Coumadin) overdose. REF: p. 355 22. For which condition would you expect the healthcare provider to prescribe iron supplementation? a. Esophageal reflux b. Constipation c. Osteoporosis d. Anemia ANS: D Iron is necessary for people with anemia caused by blood loss secondary to surgery or other conditions resulting in iron-deficiency anemia. REF: p. 356