Question 1

Decreased serum albumin levels, which are seen in many conditions, including malnutrition and liver disease, affect medications by&#10;A) leading to decreased serum levels of free fraction of a drug.&#10;B) leading to increased serum levels of free fraction of a drug.&#10;C) leading to decreased metabolism of the drug by the liver.&#10;D) leading to decreased pharmacologic effects.

Accepted Answer

Albumin is a primary carrier protein of drugs in the blood, and when albumin levels decrease, fewer binding sites for protein-bound drugs leave a larger free fraction of the protein available to leave the blood and affect target tissues. This results in an increased pharmacologic effect of the drug. Biotransformation systems in the liver and other tissues are not dependent upon albumin.

Question 2

Which of the following is an appropriate procedure for administering oral medications through a feeding tube?&#10;A) Stop the feeding and irrigate the tube with water before and after administering the medication.&#10;B) Mix the medications with water and add them to the feeding formula.&#10;C) Crush the medications, mix them with water, and then add them to feeding formula.&#10;D) Sudafed cough syrup and Robitussin expectorant may be added directly to the feeding formula.

Accepted Answer

Because of the potential for physical incompatibilities that result in the clogging of a feeding tube, medications should not be mixed directly with feeding formula. Protocols should be established in regard to which medications may be administered through a feeding tube. In these protocols, specification should be included in regard to stopping the feeding administration, irrigating the feeding tube to ensure patency, administering the medication, and irrigating the tube again with water. Sudafed and Robitussin are two medications that could lead to clogging of the feeding tube.

Question 3

Which of the following medications could be given to a patient with cancer or AIDS to stimulate food intake?&#10;A) Dextroamphetamine (Dexedrine)&#10;B) Sibutramine (Meridia)&#10;C) Phentermine (Adipex-P)&#10;D) Oxandrolone (Oxandrin)

Accepted Answer

Commonly used appetite stimulation medications include oxandrolone, megestrol acetate, somatropin, and dronabinol. Dextroamphetamine, sibutramine, and phentermine are appetite suppressant medications.

Question 4

Pseudomembranous colitis is a serious side effect of antibiotic therapy&#10;A) that results from a food-drug interaction.&#10;B) that is caused by Clostridium difficile infection.&#10;C) that can be avoided with good nutrition.&#10;D) related to hypertension.

Accepted Answer

The desired effects of medications often are accompanied by effects that are considered undesirable. Side effects are often an extension of the desired effects, such as bacterial overgrowth, as a result of use of an antibiotic. Overgrowth of C. difficile causes pseudomembranous colitis. Suppression of natural oral bacteria may lead to oral yeast overgrowth, or candidiasis.

Question 5

A patient is receiving warfarin (Coumadin). What MNT education should this patient receive?&#10;A) Decrease intake of vitamin K foods.&#10;B) Maintain consistent vitamin K intake.&#10;C) Increase intake of vitamin D and calcium-rich foods.&#10;D) Maintain consistent vitamin D intake.

Accepted Answer

For warfarin to be effective as an anticoagulant, the dose of the drug must be balanced with the amount of vitamin K consumed. Therefore, the patient needs to maintain a consistent intake of vitamin K. Decreasing the intake of vitamin K runs the risk of the patient being unable to stop bleeding. Vitamin D is not affected by warfarin therapy.

Question 6

Which of the following drugs will produced an Antabuse (disulfiram)-like reaction when taken with ethanol?&#10;A) Metronidazole (Flagyl)&#10;B) Captopril (Capoten)&#10;C) Paclitaxel (Taxol)&#10;D) Eszopiclone (Lunesta)

Accepted Answer

Metronidazole (Flagyl), cefoperazone, and chlorpropamide cause a reaction similar to that of Antabuse when taken with alcohol. The reaction is characterized by flushing, a rapid heartbeat, palpitations, and elevated blood pressure.

Question 7

Hypertensive patients who are taking loop diuretics for reduction of blood pressure may experience hypokalemia. Which other electrolyte does NOT need to be monitored for a potential secondary nutrient deficiency?

A) Magnesium
B) Sodium
C) Phosphorus
D) Calcium

Accepted Answer

Loop diuretics also promote the urinary excretion of sodium, magnesium, chloride, and calcium. With long-term use, magnesium and calcium supplementation may need to be prescribed to maintain serum blood levels. Phosphorus is not affected by loop diuretics, but care should be taken in maintaining normal levels of phosphorus because altered levels will affect calcium metabolism from bone.

Question 8

Which of the following is NOT a possible side effect of use of corticosteroids?&#10;A) Bone loss&#10;B) Hyperglycemia&#10;C) Hypotension&#10;D) Obesity

Accepted Answer

Because corticosteroids such as prednisone promote sodium and water retention, they can contribute to an increase in blood pressure. Calcium is excreted in the place of sodium, and this coupled with corticosteroid impairment of intestinal calcium absorption and osteoblast activity can lead to bone loss. Corticosteroids promote gluconeogenesis and insulin resistance, both of which can cause hyperglycemia. Weight gain is a common side effect of corticosteroids because of both fluid retention and a stimulation of appetite.

Question 9

The cancer chemotherapeutic agent methotrexate acts as an antagonist to A) thiamin. B) vitamin B₁₂. C) folate. D) vitamin B₆.

Accepted Answer

Methotrexate binds with the enzyme dihydrofolate reductase, inhibiting its activity of converting folate to its active form. This could lead to the development of megaloblastic anemia. To prevent this from happening, leucovorin, or folinic acid, is administered with methotrexate and other folate antagonists.

Question 10

An excipient is a(n)&#10;A) acetylation process.&#10;B) active ingredient in a drug.&#10;C) pressor agent.&#10;D) inactive ingredient.

Accepted Answer

An excipient is an inactive, filler ingredient, such as flavorings, dyes, and preservatives, mixed in with the active ingredient in drugs. Acetylation is a process of inactivating amines, hydrazines, and sulfonamides so as to detoxify a drug. A pressor agent is an organic compound that causes vasoconstriction and an increase in blood pressure.

Question 11

When the sedative propofol (Diprivan) is administered to a patient, what nutritional consequence must be considered?&#10;A) It can provide 1.1 kcal/ml of lipid.&#10;B) It can provide extra calcium.&#10;C) It contains lactose and may promote lactose intolerance.&#10;D) It contains wheat starch and may affect people with celiac disease.

Accepted Answer

The answer of When the sedative propofol (Diprivan) is administered...

Question 12

Which term describes the metabolism of drugs by reactions such as oxidation, reduction, hydrolysis, or conjugation?&#10;A) Bioavailability&#10;B) Biotransformation&#10;C) Excipient&#10;D) Pharmacodynamics

Accepted Answer

The answer of Which term describes the metabolism of drugs...

Question 13

Which of the following medications should not be taken with foods that contain bran?&#10;A) Alendronate (Fosamax)&#10;B) Iron supplements&#10;C) Ciprofloxacin (Cipro)&#10;D) Digoxin (Lanoxin)

Accepted Answer

The answer of Which of the following medications should not...

Question 14

A patient is being treated for depression with a monoamine oxidase inhibitor. Which of the following should the patient be instructed to avoid while taking this medication?&#10;A) Milk, soy protein, and grapefruit&#10;B) Cheese, salami, and Chianti wine&#10;C) Tomatoes, onions, and poultry&#10;D) Cantaloupe, canned pineapple, and peanuts

Accepted Answer

The answer of A patient is being treated for depression...

Question 15

Supplementation of coenzyme Q10 (CoQ10) should be considered in a patient taking which drug?&#10;A) Carbamazepine&#10;B) Methotrexate&#10;C) Lipitor&#10;D) Cholestyramine

Accepted Answer

The answer of Supplementation of coenzyme Q10 (CoQ10) should be...

Question 16

The gastrointestinal side effect commonly seen when narcotic drugs such as codeine and morphine are administered is&#10;A) a change in taste.&#10;B) constipation.&#10;C) gastrointestinal bleeding.&#10;D) anorexia.

Accepted Answer

The answer of The gastrointestinal side effect commonly seen when...

Question 17

Patients receiving the antibiotic tetracycline should be taught to avoid taking it with what?&#10;A) Fruit juices&#10;B) Meat&#10;C) Milk&#10;D) Sucrose-containing desserts

Accepted Answer

The answer of Patients receiving the antibiotic tetracycline should be...

Question 18

Patients receiving anticonvulsant medications, such as phenytoin and phenobarbital, may need to be supplemented with which nutrients?&#10;A) Ascorbic acid and vitamin A&#10;B) Ascorbic acid and vitamin D&#10;C) Folate and vitamin D&#10;D) Iron and vitamin A

Accepted Answer

The answer of Patients receiving anticonvulsant medications, such as phenytoin...

Question 19

Antacids, H₂-receptor antagonists, and proton pump inhibitors affect the absorption of calcium, iron, and magnesium through A) decreased bioavailability caused by change in gastrointestinal pH. B) decreased bioavailability caused by inhibition of small intestine enzymes. C) decreased bioavailability caused by damage to the intestinal mucosa. D) increased bioavailability caused by change in gastrointestinal pH.

Accepted Answer

The answer of Antacids, H₂-receptor antagonists, and proton pump inhibitors...

Question 20

Which term is used to describe the movement of a drug through the body by absorption, distribution, metabolism, and excretion?&#10;A) Pharmacodynamics&#10;B) Pharmacogenomics&#10;C) Pharmacokinetics&#10;D) Polypharmacy

Accepted Answer

The answer of Which term is used to describe the...

Deck 8: Clinical: Food-Drug Interactions