A 42-year-old woman who is a chemist is brought to the emergency department because of a 1-hour history of severe abdominal cramps, nausea and vomiting, hypotension, bradycardia, sweating, and difficulty breathing due to bronchospasm and congestion. Exposure to which of the following is most likely?

Correct Answer: C

Rationale: These symptoms (abdominal cramps, nausea, vomiting, hypotension, bradycardia, sweating, bronchospasm) suggest cholinergic toxicity from an organophosphate like isoflurophate (DFP, C), an irreversible cholinesterase inhibitor. As a chemist, she could have been exposeAcrylamide causes neurotoxicity, cyanogen bromide cyanide poisoning (tachycardia, not bradycardia), phentolamine alpha-blockade (hypotension without bronchospasm), and propranolol (E) beta-blockade (bradycardia without cholinergic signs)—none match this full picture.

Correct Answer: C

Rationale: Metoprolol, a beta-blocker, slows heart rate and lowers blood pressure. Assessing heart rate is critical before administration; if <50-60 bpm (depending on protocol), the dose may be held to avoid bradycardiRespirations and O2 saturation are relevant for respiratory drugs, temperature is unrelateNote: Answer key says (b), but is correct per nursing standards.

Correct Answer: C

Rationale: The correct answer is C: Premedicate with aspirin. Aspirin can help reduce the flushing side effect of niacin by inhibiting prostaglandin synthesis. This step can help the patient tolerate niacin better without experiencing the redness. Discontinuing the medication (Choice A) is not necessary if the flushing can be managed. Drinking water (Choice B) or taking the medication with food (Choice D) may not effectively address the flushing side effect caused by niacin.

Correct Answer: B

Rationale: The correct answer is B because isotretinoin is known to be highly teratogenic and can cause severe birth defects when taken during pregnancy. This is why it is contraindicated in pregnant women and effective contraception is required before, during, and after treatment. Intravenous administration of isotretinoin is not necessary for the treatment of acne and is typically administered orally. Choice A is incorrect.

Correct Answer: A

Rationale: The correct answer is A: Timing of administration. This is because the timing of administration may influence the pharmacokinetics of the drug but does not necessarily determine the response of the drug itself. Dosage (B), route (C), and frequency (D) are all crucial factors that directly impact the drug's efficacy, safety, and therapeutic effects. Dosage determines the amount of drug reaching the target site, route affects the absorption and distribution of the drug, and frequency determines the duration and intensity of drug action. Therefore, while timing is important for optimal drug effectiveness in some cases, it is not as critical in determining the overall response of a drug compared to dosage, route, and frequency.