A nurse is explaining drug metabolism to a nursing student who asks about glucuronidation. The nurse knows that this is a process that allows drugs to be:

Excreted in hydrolyzed form in the feces to reduce drug toxicity.

Transported across the renal tubules to be excreted in the urine.

Recycled within the enterohepatic recirculation to remain in the body longer.

Reabsorbed from the urine into the renal circulation to minimize drug loss.

Answer and Explanation

The Correct Answer is B

Choice A reason: Glucuronidation does not primarily involve fecal excretion; it conjugates drugs for urinary excretion. Hydrolysis is unrelated, and fecal routes are secondary, so this is incorrect for glucuronidation’s role.

Choice B reason: Glucuronidation conjugates drugs, making them water-soluble for transport across renal tubules and excretion in urine. This is the primary mechanism, making it the correct choice for drug elimination.

Choice C reason: Enterohepatic recirculation involves some drugs, but glucuronidation aims for excretion, not recycling. Prolonging drug presence is not the goal, so this is incorrect for the process.

Choice D reason: Glucuronidation facilitates excretion, not reabsorption. Reabsorbing drugs would counteract its purpose of eliminating metabolites, making this incorrect compared to urinary excretion.

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Correct Answer is B

Explanation

Choice A reason: Hydrochlorothiazide is for chronic hypertension, not acute pulmonary edema. Furosemide acts rapidly to relieve fluid overload, so this is incorrect for emergency use.

Choice B reason: Furosemide is the drug of choice for pulmonary edema, rapidly reducing fluid overload and relieving symptoms like frothy sputum. This is the correct choice.

Choice C reason: Mannitol is used for cerebral edema, not pulmonary edema. Furosemide targets acute fluid overload in the lungs, so this is incorrect for this scenario.

Choice D reason: Spironolactone is for chronic heart failure, not acute pulmonary edema. Furosemide’s rapid diuresis is needed, so this is incorrect for immediate treatment.

A. Gastric cancer B. Osteoporosis C. Vitamin and mineral deficiencies D. Headaches E. Medication interactions

Correct Answer is ["B","C","E"]

Explanation

Choice A reason: Long-term proton pump inhibitor (PPI) use has a weak, controversial association with gastric cancer due to hypergastrinemia, but evidence is inconclusive. In older patients, risks like osteoporosis and nutrient deficiencies are more established and immediate concerns, making this choice less consistently worrisome compared to others.

Choice B reason: PPIs reduce gastric acid, impairing calcium absorption, which increases osteoporosis risk in older patients. Chronic use is linked to decreased bone density and higher fracture risk, particularly in the elderly, due to disrupted mineral homeostasis, making this a significant and correct adverse effect to monitor.

Choice C reason: PPIs inhibit acid production, reducing absorption of vitamin B12, magnesium, and iron, leading to deficiencies in older patients. These can cause anemia, neurological issues, or hypomagnesemia, which are particularly concerning in the elderly due to comorbidities, making this a correct and critical adverse effect.

Choice D reason: Headaches are a possible PPI side effect but are less common and less severe in older patients compared to osteoporosis, nutrient deficiencies, or drug interactions. They don’t pose a significant long-term risk or require specific monitoring, making this choice incorrect for major concerns.

Choice E reason: PPIs interact with drugs like clopidogrel, reducing its efficacy by inhibiting CYP2C19, and affect absorption of drugs requiring acidic environments. In older patients with polypharmacy, these interactions increase risks of adverse outcomes, making this a significant and correct concern for PPI use.

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A nurse is explaining drug metabolism to a nursing student who asks about glucuronidation. The nurse knows that this is a process that allows drugs to be:

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Naxlex Comprehensive Predictor Exams

A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug?

Correct Answer is B

Explanation

Which are potentially worrisome adverse effects associated with proton pump inhibitor use in older patients? (Select all that apply)

Correct Answer is ["B","C","E"]

Explanation

A patient who is taking morphine for pain asks the nurse how a pain medication can also cause constipation. What does the nurse know about morphine?

A patient newly diagnosed with type 1 diabetes asks a nurse, “How does insulin normally work in my body?” The nurse explains that normal insulin has which action in the body?

A cancer patient asks the nurse what can be given to alleviate severe, chronic pain of several months’ duration. The patient has been taking oxycodone (OxyContin) and states it is no longer effective. The nurse will suggest discussing which medication with the provider?

When administering a central nervous system depressant, the nurse should closely observe for drug toxicity in which patient?

A patient with type 1 diabetes reports mixing NPH and regular insulin to allow for one injection. The nurse knows:

A patient who has type 2 diabetes will begin taking glipizide (Glucotrol). Which statement by the patient is concerning to the nurse?

A patient who was in a motor vehicle accident sustained a severe head injury and is brought to the emergency department. The provider orders intravenous mannitol (Osmitrol). The nurse knows that this is given to:

The nurse is preparing to give a medication for pain. The label states that the drug is “lipid soluble.” How soon should the nurse expect to observe the effects of the drug?