A 42-year-old man is diagnosed with diabetes mellitus. He has tried diet and exercise without success. A second-generation sulfonylurea agent is prescribed. Which of the following is the most likely side effect he will experience?

Correct Answer: A

Rationale: In this scenario, the most likely side effect the 42-year-old man will experience after being prescribed a second-generation sulfonylurea agent for diabetes mellitus is hypoglycemia. Sulfonylureas work by stimulating insulin release from the pancreas, which can lead to a rapid decrease in blood sugar levels. A) Hypoglycemia is the correct answer because sulfonylureas can cause blood sugar levels to drop too low, resulting in symptoms like sweating, dizziness, confusion, and even loss of consciousness. B) Lactic acidosis is a potential side effect of biguanides like metformin, not sulfonylureas. C) Myositis is not a common side effect associated with sulfonylureas. It is more commonly seen with statins, which are used to lower cholesterol levels. D) Pruritus (itching) is not a typical side effect of sulfonylureas. It is often associated with allergic reactions or skin conditions. Educationally, understanding the side effects of different classes of medications used to manage diabetes is crucial for healthcare professionals to provide safe and effective care to patients. Recognizing the potential side effects of sulfonylureas, like hypoglycemia, can help healthcare providers monitor and manage patients appropriately to prevent complications.

Correct Answer: A

Rationale: DES, a synthetic estrogen, causes deep vein thrombosis (choice A), feminization of male offspring (choice B), and miscarriages (choice C) in pregnancy, linked to historical congenital anomalies (e.g., vaginal adenocarcinoma). Virilization of female offspring (choice D) isn't reported; DES mimics estrogen, not androgens. This exception highlights its teratogenic risks, banning its use in pregnancy.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Thioridazine. Thioridazine belongs to a class of antipsychotic drugs known as phenothiazines, and in excess doses, it can lead to cardiac arrhythmias due to its potential to prolong the QT interval, which can result in serious heart rhythm abnormalities. Chlorpromazine (option A) is also a phenothiazine antipsychotic, but it is not as strongly associated with causing cardiac arrhythmias as thioridazine. Clozapine (option B) is an atypical antipsychotic known for its potential side effects such as agranulocytosis but is not typically linked to cardiac arrhythmias. Haloperidol (option D) is a typical antipsychotic that is less likely to cause cardiac arrhythmias compared to thioridazine. In an educational context, understanding the side effect profiles of different antipsychotic medications is crucial for healthcare professionals, especially when managing patients with psychiatric conditions. Knowledge of the potential cardiac effects of certain antipsychotics like thioridazine can guide clinical decision-making to prevent serious complications in patients. Nurses, pharmacists, and other healthcare providers need to be well-versed in the adverse effects of medications to ensure safe and effective patient care.

Correct Answer: B

Rationale: The correct answer is B) LSD acts on various 5-HT receptors to produce its effects. This is true because LSD (lysergic acid diethylamide) is a hallucinogenic drug that primarily acts on serotonin (5-HT) receptors in the brain, particularly the 5-HT2A receptor subtype. By binding to these receptors, LSD alters sensory perception, mood, and thought processes, leading to its characteristic hallucinogenic effects. Option A is incorrect because Ketamine is not structurally related to psilocybin. Ketamine is a dissociative anesthetic that acts primarily on NMDA receptors in the brain, while psilocybin is the active compound in hallucinogenic mushrooms. Option C is incorrect because marijuana does not typically cause mydriasis (pupil dilation) and conjunctival injection (red eyes). These effects are more commonly associated with drugs like cocaine or amphetamines. Option D is incorrect because cocaine actually has a relatively short plasma half-life, typically around 1 hour. This rapid metabolism contributes to its short-lived effects and the cycle of craving and repeated dosing seen in cocaine abuse. In an educational context, understanding how different drugs interact with specific receptors in the brain can help healthcare professionals make informed decisions about patient care, especially in cases of substance abuse or overdose. Knowledge of the pharmacological actions of drugs of abuse is crucial for nurses, pharmacists, and other healthcare providers to effectively manage and treat patients with substance-related issues.

Correct Answer: D

Rationale: In the context of Central Nervous System (CNS) stimulants and related drugs, understanding the pharmacology of ketamine is crucial for nursing practice. The correct answer, option D, stating that ketamine is contraindicated in sick sinus syndrome, is accurate because ketamine can exacerbate cardiac arrhythmias and should be avoided in patients with preexisting cardiac conduction abnormalities. Option A, stating that ketamine has a rapid onset of action, is incorrect as ketamine actually has a slower onset compared to other anesthetics. Option B, mentioning that ketamine is partially renally excreted, is also incorrect as ketamine is primarily metabolized in the liver. Option C, claiming that ketamine has no neurological side effects, is misleading as ketamine is known to cause side effects such as hallucinations and delirium. In an educational context, it is important for nursing students preparing for the NCLEX to understand the specific pharmacological properties and contraindications of CNS stimulants and related drugs like ketamine. By comprehensively reviewing each option and understanding why the correct answer is right while the others are wrong, students can enhance their critical thinking skills and improve their ability to answer similar questions on the exam.