A 22-year-old man has taken an overdose of sleeping pills after learning that he did not receive the job he has recently been interviewed for. He is found by his roommate conscious but not able to completely follow commands. The roommate calls the local poison control center. Instructions are given to self-administer syrup of ipecac while waiting for the rescue squad to respond. This agent has a mechanism of action that involves which of the following?

Correct Answer: B

Rationale: Syrup of ipecac induces vomiting in overdose. It stimulates the chemotactic trigger zone in the medulla-prompting emesis. Gag reflex stimulation is secondary. Suppressing pressures , gag reflex , or motor cortex (E) don't apply. Though less used now, ipecac's CNS action expels pills, aiding this acute scenario, distinct from mechanical or suppressive effects.

Correct Answer: C

Rationale: Levetiracetam treats post-stroke focal seizures by modulating SV2A, offering efficacy, minimal hepatic metabolism, and low interaction risk, ideal for an elderly patient with likely polypharmacy. Phenytoin, a sodium channel blocker, controls seizures but has nonlinear kinetics and P450 induction, risking toxicity. Oxcarbazepine, similar to carbamazepine, has hyponatremia risks, concerning in the elderly. Phenobarbital sedates and interacts via P450. Levetiracetam's safety, renal clearance, and effectiveness in stroke-related epilepsy, per guidelines, make it the most appropriate here.

Correct Answer: C

Rationale: Morphine, a potent opioid analgesic, is primarily used to manage moderate to severe pain, but its established clinical applications extend beyond analgesia. One well-documented use is in treating pulmonary congestion, particularly in acute pulmonary edema associated with heart failure. Morphine reduces preload by causing vasodilation, alleviating dyspnea and anxiety in these patients, though the exact mechanism is multifaceted and includes central effects on respiration. Managing generalized anxiety disorders is not a standard use, as anxiolytics like benzodiazepines are preferred. While morphine can relieve pain, its use in biliary colic is contraindicated because it causes sphincter of Oddi constriction, potentially worsening the condition. It is not a treatment for ACE inhibitor-induced cough, which is better managed with antitussives or drug discontinuation. Suppression of ethanol withdrawal is also not an established role, as benzodiazepines are the standard. Thus, pulmonary congestion stands out as a recognized therapeutic use.

Correct Answer: B

Rationale: Fluticasone, a corticosteroid, is contraindicated with active infections (e.g., viral colds) due to immunosuppression risks . 'My kids have a head cold' suggests exposure, prompting nurse-prescriber collaboration to assess infection status. Licorice , psoriasis , and fruit don't contraindicate use. Choice B prioritizes safety, avoiding exacerbation of undetected infection.

Correct Answer: A

Rationale: Metoclopramide, a D2 antagonist, causes acute dystonia (e.g., oculogyric crisis). Procyclidine, an anticholinergic, rapidly reverses this IV, relaxing muscles, a suitable treatment. Benzhexol (trihexyphenidyl) works orally but is slower. Levodopa and bromocriptine, dopamine agonists, treat Parkinson's, not dystonia from dopamine blockade. Risperidone worsens it. IV procyclidine's speed is critical in acute settings, restoring normal movement effectively.