A 3-year-old girl was found by her mother chewing on some weeds in their flower garden. The mother rushed her to the hospital along with a portion of the weed. The emergency department physician identifies the weed as deadly nightshade, which contains atropine. Which of the following physiologic changes will be expected because of this patient's atropine exposure?

Correct Answer: B

Rationale: Deadly nightshade (atropine) blocks muscarinic receptors. Decreased gastric acid secretion is correct-atropine inhibits parasympathetic stimulation of parietal cells. Bradycardia is wrong; tachycardia occurs. Increased bronchial secretions and salivation decrease, as does miosis (E)-pupils dilate. This anticholinergic effect explains the expected change in this poisoning.

Correct Answer: B

Rationale: Interleukin 2 is administered intravenously because it is a protein that would be broken down in the digestive system if taken orally. Epoetin alfa, granulocyte colony–stimulating factor (G-CSF), and granulocyte-macrophage colony–stimulating factor (GM-CSF) can be administered subcutaneously. The nurse should ensure proper administration of interleukin 2 and monitor for side effects, such as capillary leak syndrome, which can cause fluid retention and hypotension.

Correct Answer: A

Rationale: Lithium is commonly used as a mood stabilizer in the treatment of bipolar disorder. One of its main therapeutic effects is its ability to prevent or decrease the incidence of acute manic episodes in individuals with bipolar disorder. Lithium can help stabilize mood swings and reduce the severity and frequency of manic episodes. By regulating neurotransmitter levels in the brain, lithium helps to balance mood and prevent the extreme highs associated with mania. It is an essential medication for managing bipolar disorder and is particularly effective in treating manic symptoms.

Correct Answer: D

Rationale: Valproate is a medication commonly used to treat seizures and prevent migraine headaches. It acts by suppressing seizure activity and stabilizing electrical activity in the brain. Valproate is a broad-spectrum anticonvulsant drug that can be an effective treatment for epilepsy and migraine prophylaxis. It works by increasing the levels of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity, thus reducing the frequency and severity of seizures and migraine attacks. Glipizide is an oral antidiabetic drug used to treat type 2 diabetes, hydrochlorothiazide is a diuretic used to treat high blood pressure, and atropine is a medication with various uses, including dilating the pupils and reducing secretions during surgery.

Correct Answer: C

Rationale: Naloxone is a medication used to treat opioid overdose by rapidly reversing the effects of opioids on the central nervous system. It works by binding to the same receptors in the brain that opioids target, effectively displacing the opioids and reversing their effects. Naloxone can quickly restore normal breathing in individuals who have overdosed on opioids, potentially saving their lives. It is commonly administered in emergency situations, such as in hospitals, ambulances, and by first responders. Naloxone is an essential tool in treating opioid overdose and is considered a life-saving medication in such cases.

Correct Answer: D

Rationale: Antiepileptics vary in side effects. Valproate causes tremor or hepatotoxicity, not visual defects. Carbamazepine risks rash or hyponatremia, not eyes. Lamotrigine is linked to rash, tiagabine to dizziness, without visual impact. Vigabatrin, a GABA-transaminase inhibitor, causes irreversible concentric visual field defects in ~30-40% of users due to retinal toxicity, a unique and serious adverse effect. This necessitates ophthalmologic monitoring, distinguishing it in epilepsy treatment choices.

Correct Answer: B

Rationale: Deadly nightshade (atropine) blocks muscarinic receptors. Decreased gastric acid secretion is correct-atropine inhibits parasympathetic stimulation of parietal cells. Bradycardia is wrong; tachycardia occurs. Increased bronchial secretions and salivation decrease, as does miosis (E)-pupils dilate. This anticholinergic effect explains the expected change in this poisoning.

Correct Answer: A

Rationale: Nicotinic acid, also known as niacin, is commonly associated with adverse effects of pruritus (itching) and cutaneous flushing (reddening of the skin). These effects are often dose-related and can be minimized if the medication is taken with food or slowly titrated up. Tinnitus and urine with a burnt odor are not typically associated with nicotinic acid. Myalgia (muscle pain) and fatigue are more commonly seen with statin medications rather than niacin. Blurred vision and headaches are not commonly reported side effects of nicotinic acid either.

Correct Answer: B

Rationale: Bioavailability quantifies the extent of systemic drug absorption after oral administration, often expressed as a ratio of oral AUC to intravenous AUC.