Reference no: EM133543459
Questions
1. A man and his wife are both taking warfarin (Coumadin) daily because of atrial fibrillation. The husband asks why he is prescribed a much smaller than average dose of the drug to keep his international normalized ratio (INR) at 2.0 and his wife takes the average dose even though he is taller and heavier than she is. What is the nurse's best response?
"You probably absorb vitamin K much less efficiently than your wife does, so you don't need as much warfarin to prevent formation of vitamin K dependent clotting factors."
"Body size is not important for warfarin but gender differences are because testosterone improves its action."
"You are probably anemic, which would reduce your ability to form blood clots, so your doses can be lower."
"Some people do not break down warfarin as fast as others do, so the drug is more effective at lower dosages."
2. A patient reports that he has G6PD (glucose-6-phosphate dehydrogenase) deficiency. For this patient, the medication_______ poses a risk for ____
azathioprine; renal failure
warfarin; liver failure
isoniazid; dysrhythmia
aspirin; hemolytic anemia
3. A patient is identified as an ultra-rapid metabolizer for drugs that are prepared for elimination by CYP2D6. What effect will thWhat effect will this have on the patient's ability to benefit from any active drug that is metabolized by this enzyme?
Intended responses increase while side effects decrease.
Intended responses decrease while side effects increase.
Both intended responses and side effects increase.
Both intended responses and side effects decrease.
4. A patient reports that he has always been seemingly unaffected by caffeine. He can drink "practically an entire pot of coffee" at dinner and be quite sleepy afterwards if he's had a big meal.
It's possible that this patient is has increased activity of ________________________, and that he may also be better able to metabolize _______________.
N-acetyltransferase (NAT); nicotine
N-acetyltransferase (NAT) ; some antibiotics
TPMT (thiopurine methyl-transferase; certain kinds of chemotherapy
CYP3A; verapamil (a calcium channel blocker)
5. A nurse is caring for a child with acute lymphoblastic leukemia. The child has been genotyped and is homozygous for a TPMT polymorphism, producing very little of the enzyme needed for this drug's metabolism. How would the nurse expect this to affect dosing of the drug 6-mercaptopurine?
This child should receive the drug intravenously rather than orally.
The child should not receive this drug at all for chemotherapy.
This child should receive higher doses than the standard dose.
This child should receive only a small fraction of the standard dose.
6. Your patient's direct-to-consumer testing revealed that her CYP2D6 status causes her to be a poor metabolizer. What might happen when she begins to take flecainide for her paroxysmal atrial fibrillation?
She might eliminate the drug faster than she can absorb it
She may experience toxic levels of the drug even when it is given at standard doses
The drug may have poor clinical efficacy in her case
She might exhibit high enzyme activity
7. Which statement regarding the biology of cancer is always true?
The biggest risk factor for cancer development is having a first-degree relative with cancer.
Cancer cells arise from normal cells.
With each division, cancer cells increase the numbers of their telomeres.
Cancers are caused by amplification of proto-oncogenes and deletion of tumor suppressor genes.
8. A characteristic of benign tumors is that that they:
grow by expansion rather than invasion
retain a euploid number of chromosomes
grow by hypertrophy rather than hyperplasia
perform fewer differentiated functions