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Why are Verapamil and Diltiazem considered to be antidysrhythmic medications but Nifedipine is not, if all three medications are calcium channel blockers?

Nifedipine is a dihydropyridine and therefore only affects the movement of calcium into the cells of vascular smooth muscle.

Verapamil and Diltiazem affect the movement of calcium into the cells of both the heart and blood vessels.

All three medications have antidysrhythmic properties.

Nifedipine affects the movement of calcium into the cells of both the heart and blood vessels.

Answer and Explanation

The Correct Answer is B

Choice A reason:
Nifedipine is a dihydropyridine calcium channel blocker that primarily affects vascular smooth muscle, leading to vasodilation. While it can lower blood pressure, it does not significantly affect cardiac conduction or rhythm, which is why it is not used as an antidysrhythmic.

Choice B reason:
Verapamil and Diltiazem are calcium channel blockers that affect the movement of calcium into the cells of both the heart and blood vessels. They have a significant impact on cardiac conduction and can be used to treat arrhythmias by slowing down the heart rate and reducing the conduction through the atrioventricular node.

Choice C reason:
Not all three medications have antidysrhythmic properties. Only Verapamil and Diltiazem are effective as antidysrhythmic agents due to their effects on cardiac conduction. Nifedipine does not share these properties and is therefore not used to manage arrhythmias.

Choice D reason:
Nifedipine primarily affects the movement of calcium into the cells of vascular smooth muscle, not the heart. Its main use is in the treatment of hypertension and angina, where its vasodilatory effects are beneficial. It does not significantly impact cardiac rhythm or conduction like Verapamil and Diltiazem do.

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Correct Answer is ["A","D","E"]

Explanation

Choice A reason: H. pylori infection is a well-known cause of duodenal ulcers. This bacterium damages the protective lining of the stomach and duodenum, leading to inflammation and ulceration. It is one of the most common causes of peptic ulcers worldwide.
Choice D reason: Nonsteroidal anti-inflammatory drugs (NSAIDs) are another primary cause of duodenal ulcers. These medications can irritate the stomach lining and increase acid production, leading to ulcer formation. Long-term use of NSAIDs is particularly associated with this risk.
E reason: Chronic alcohol (ETOH) abuse can also lead to duodenal ulcers. Alcohol irritates the stomach lining and increases acid production, which can contribute to the development of ulcers. Additionally, alcohol abuse can impair the healing process of existing ulcers.
Choice B reason: Side effects of antibiotics are not typically associated with the primary causes of duodenal ulcers. While antibiotics can cause gastrointestinal disturbances, they are not a common cause of ulcer formation.
Choice C reason: Trauma is not a primary cause of duodenal ulcers. While severe physical stress or injury can lead to stress ulcers, these are different from the typical duodenal ulcers caused by H. pylori infection, NSAIDs, or chronic alcohol abuse.

A. The drug will be most effective when given orally. B. The drug will be more effective when given in a non-enteral route (IV, SQ). C. The drug whether given oral or IV will have the same effect. D. The drug is excreted by the lungs at a slower rate than most medications.

Correct Answer is B

Explanation

Choice A reason:
Morphine is not most effective when given orally due to the high first-pass effect. The first-pass effect refers to the metabolism of a drug in the liver immediately after it enters the bloodstream from the gastrointestinal tract, significantly reducing the amount of active drug that reaches systemic circulation. Therefore, oral administration of morphine is not the most effective route because much of it is metabolized before it can exert its effect.

Choice B reason:
Morphine will be more effective when given via a non-enteral route such as intravenous (IV) or subcutaneous (SQ) because these routes bypass the liver, thereby avoiding the first-pass metabolism. This allows a higher concentration of the active drug to reach the systemic circulation, providing a more potent and effective pain relief.

Choice C reason:
Oral and IV administration of morphine do not have the same effect due to the first-pass metabolism. When morphine is administered orally, a significant amount is metabolized by the liver before it reaches the systemic circulation, whereas IV administration delivers the drug directly into the bloodstream, bypassing the liver and allowing a higher active concentration.

Choice D reason:
Morphine is not primarily excreted by the lungs; it is mainly metabolized by the liver and excreted by the kidneys. This statement does not accurately demonstrate an understanding of the first-pass effect or the pharmacokinetics of morphine.

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Why are Verapamil and Diltiazem considered to be antidysrhythmic medications but Nifedipine is not, if all three medications are calcium channel blockers?

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Naxlex Comprehensive Predictor Exams

The primary causes of duodenal ulcers include:

Correct Answer is ["A","D","E"]

Explanation

A nurse reads in a drug information guide that PO (oral) morphine has a high first-pass effect. Which of the following statements would demonstrate the nurse's understanding of the first-pass effect?

Correct Answer is B

Explanation

A postoperative patient reports a new pain in the left lower extremity. The nurse notes swelling in the lower leg, which feels warm to the touch. The nurse notifies the MD of the patient's change in condition. Which medication will the RN anticipate giving?

Patients with acute pancreatitis are generally made NPO (nothing by mouth) and may require gastric suctioning via NG tube, in order to:

A 19-year-old presents with abdominal pain in the right lower quadrant. Physical examination reveals rebound tenderness and a low-grade fever. A possible diagnosis would be:

A patient with a history of chronic alcohol abuse has been admitted to the unit with cirrhosis. Upon review of the patient's laboratory test results, the nurse notes that the patient's ammonia level is elevated at 218 mcg/dL. What medication should the nurse prepare to administer?

When a patient asks the nurse what is the most common cause of myocardial ischemia, which statement is the correct response?

Which medication blocks the efflux (outflow) of potassium at the heart muscle?

A patient with a history of atherosclerosis complains of chest pain that is consistent at rest. The pain does not improve after sublingual Nitroglycerin. The likely cause of this pain is:

A 31-year-old female is diagnosed with acute pancreatitis. Which of the following will be part of the treatment plan?