A 35-year-old African American male in the military is hospitalized with an MRSA skin infection. The patient starts treatment with an antibiotic and becomes anemic and jaundiced. On peripheral blood smear, Heinz bodies are seen within red blood cells. What is the mechanism of action of the antibiotic given to this patient?

Correct Answer: D

Rationale: MRSA treatment causing anemia, jaundice, and Heinz bodies suggests dapsone (sulfa drug), which inhibits folic acid metabolism . Oxidative stress from dapsone in G6PD-deficient patients (common in African Americans) leads to hemolysis. Options and are macrolide and tetracycline mechanisms. Option is penicillin's action. RNA polymerase inhibition (E) is rifampin's. Dapsone's sulfa action fits the clinical picture, with hemolysis as a side effect, not its primary MRSA mechanism, but the question's focus on outcome aligns with folate pathway disruption.

Correct Answer: D

Rationale: Prednisone is a corticosteroid medication that can cause side effects such as fluid retention, electrolyte imbalance, and increased blood pressure. On the other hand, high-dose aspirin, especially when taken for arthritis, can have blood-thinning effects that may also contribute to lowering blood pressure. Given these potential effects of both medications, the nurse should be vigilant for the development of hypotension in the patient. Monitoring for signs and symptoms of low blood pressure, such as dizziness, lightheadedness, and weakness, is crucial in this situation to ensure the patient's safety.

Correct Answer: B

Rationale: The nurse's best response would be, "It takes 6 to 8 weeks to see a change in cholesterol levels." Statin drugs typically take around 6 to 8 weeks before a noticeable effect on serum cholesterol levels is seen. This timeframe allows the medication to fully take effect and lower the cholesterol levels in the blood. Patients should continue with the prescribed treatment regimen and have their cholesterol levels monitored regularly to assess the effectiveness of the medication.

Correct Answer: B

Rationale: IV calcium risks infiltration-site assessment (e.g., swelling) ensures safety, per protocol. Glucose/potassium aren't directly tied-edema is secondary. Site check prevents complications, per administration.

Correct Answer: B

Rationale: Bimatoprost for eyelashes risks permanent iris darkening , increasing melanin, especially in light eyes. Glaucoma is its therapeutic use, not a side effect here. Stevens-Johnson , weight gain , and migraines (E) aren't linked. Darkening is a key cosmetic concern.

Correct Answer: D

Rationale: The therapeutic range for lithium is generally considered to be 0.6-1.2 mmol/L (which is equivalent to 0.6-1.2 mEq/L). However, some sources may state a slightly wider range of 0.5-1.5 mEq/L. It is important to note that individual patient factors and clinical judgment should also be considered when interpreting lithium levels. Levels below the therapeutic range may be subtherapeutic and not provide the desired therapeutic effect, while levels above the range may result in toxicity and adverse effects. Monitoring lithium levels regularly is important to ensure they remain within the therapeutic range.

Correct Answer: A

Rationale: Most drugs are absorbed through passive diffusion across the gastrointestinal tract, following a concentration gradient, especially non-ionized forms.

Correct Answer: A

Rationale: The therapeutic serum range for phenobarbital (luminal) when used for anxiety is typically between 5-10 mcg/ml. This range is considered effective in controlling anxiety symptoms while minimizing the risk of toxicity. Higher serum levels (options B, C, D) may increase the risk of adverse effects such as sedation, respiratory depression, and overdose. Therefore, monitoring the serum levels of phenobarbital is essential to ensure the medication is at a therapeutic range for the intended treatment.

Correct Answer: D

Rationale: MRSA treatment causing anemia, jaundice, and Heinz bodies suggests dapsone (sulfa drug), which inhibits folic acid metabolism . Oxidative stress from dapsone in G6PD-deficient patients (common in African Americans) leads to hemolysis. Options and are macrolide and tetracycline mechanisms. Option is penicillin's action. RNA polymerase inhibition (E) is rifampin's. Dapsone's sulfa action fits the clinical picture, with hemolysis as a side effect, not its primary MRSA mechanism, but the question's focus on outcome aligns with folate pathway disruption.