A 34-year-old woman with chronic irritable bowel syndrome with predominance of diarrhea and left lower quadrant pain begins smoking in response to the numerous stresses in her personal and professional life. She smokes one pack per day. She presents to her primary care physician for treatment of her irritable bowel syndrome. The physician expects a change in which of the following symptoms of her irritable bowel syndrome?

Correct Answer: A

Rationale: The correct answer is A) Diarrhea. The woman's smoking habit of one pack per day can lead to the exacerbation of her chronic irritable bowel syndrome symptoms, particularly diarrhea. Nicotine in cigarettes can stimulate the bowel movements and increase gut motility, worsening diarrhea in individuals with irritable bowel syndrome. Option B) Muscle aches is incorrect because smoking is not directly linked to causing muscle aches in irritable bowel syndrome. Option C) Right lower quadrant pain and Option D) Right upper quadrant pain are incorrect as they are not typically associated with irritable bowel syndrome, especially in the context of smoking exacerbating symptoms. Educational Context: Understanding the potential effects of smoking on irritable bowel syndrome symptoms is crucial for healthcare providers to effectively manage and treat patients. Educating patients on the negative impact of smoking on gastrointestinal health can aid in symptom management and overall well-being. Health promotion strategies should include smoking cessation interventions to improve the outcomes for patients with irritable bowel syndrome.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Anticholinergic effects. Low-potency typical antipsychotics, such as chlorpromazine, typically have higher anticholinergic side effects due to their pharmacological properties. Anticholinergic effects include dry mouth, constipation, blurred vision, and urinary retention. When switching to a high-potency antipsychotic like haloperidol, which has lower anticholinergic properties, these side effects are likely to diminish. Option B) Parkinsonism is a side effect common to both low and high-potency antipsychotics due to dopamine receptor blockade. Therefore, switching from low to high-potency may not necessarily diminish Parkinsonism. Option C) Perioral tremor is not specifically associated with antipsychotic potency but rather with individual drug profiles. Switching potency may not directly impact perioral tremor. Option D) Tardive dyskinesia is a late side effect of antipsychotic use, more common with long-term usage of all antipsychotics, especially typical ones. Switching potency may not reduce the risk of tardive dyskinesia significantly. Educationally, understanding the differences in antipsychotic side effects based on potency is crucial for nursing practice, especially in managing side effects and optimizing patient care. Nurses need to be aware of the various side effects associated with different antipsychotics to provide safe and effective care to patients with schizophrenia or other psychiatric disorders.

Correct Answer: D

Rationale: Educational Rationale: The correct answer is D) Increases synaptic acetylcholine. Donepezil is a cholinesterase inhibitor commonly used to treat symptoms of Alzheimer's disease. By inhibiting the enzyme that breaks down acetylcholine in the synaptic cleft, donepezil increases the levels of acetylcholine available for neurotransmission. This helps improve cognitive function in patients with Alzheimer's by enhancing cholinergic transmission in the brain. Option A) Decreases synaptic acetylcholine is incorrect because donepezil actually increases synaptic acetylcholine levels. Option B) Decreases synaptic dopamine is incorrect as donepezil does not have a direct effect on dopamine levels. Option C) Decreases synaptic norepinephrine is incorrect because donepezil primarily affects acetylcholine levels and does not significantly impact norepinephrine transmission. In an educational context, understanding the mechanism of action of drugs like donepezil is crucial for nurses and healthcare professionals caring for patients with Alzheimer's disease. By knowing how donepezil works to increase acetylcholine levels, healthcare providers can better understand its therapeutic effects and potential side effects, thus optimizing patient care and outcomes.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Doxylamine. Doxylamine is an antihistamine commonly used to relieve symptoms of allergies, colds, and hay fever. One of the common side effects of first-generation antihistamines like doxylamine is drowsiness due to their sedating properties. Therefore, it is likely causing the 21-year-old woman to feel sleepy. A) Amantadine is a medication used to treat Parkinson's disease and influenza. It works by stimulating the central nervous system and is not known to cause drowsiness. B) Cimetidine is a histamine-2 blocker used to reduce stomach acid production. It is not associated with drowsiness. D) Famotidine is also a histamine-2 blocker used to treat conditions like heartburn and stomach ulcers. It is not known to cause drowsiness. In an educational context, it is crucial for healthcare professionals to be able to identify medications that can potentially cause drowsiness in patients. Understanding the side effects of common medications allows for appropriate patient education and management of symptoms. Educating patients about the potential side effects of their medications can lead to better adherence and outcomes.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Diazepam. Diazepam has a longer half-life compared to the other benzodiazepines listed (Flurazepam, Temazepam, Triazolam), which means it is metabolized more slowly in the body. This slower metabolism leads to a less severe withdrawal reaction when the medication is abruptly discontinued. Flurazepam, Temazepam, and Triazolam have shorter half-lives, making them more likely to cause a more intense withdrawal reaction due to their quicker elimination from the body. This can result in rapid onset of withdrawal symptoms such as rebound anxiety, insomnia, tremors, and even seizures in some cases. Educationally, understanding the pharmacokinetics of benzodiazepines is crucial for healthcare providers to make informed decisions when prescribing these medications, especially for patients who may struggle with compliance. Knowing which benzodiazepine has a longer half-life, like Diazepam, can help prevent severe withdrawal reactions and ensure patient safety and treatment efficacy.