A 52-year-old man has had several focal complex partial seizures over the last year. Which one of the following therapies would be the most appropriate initial therapy for this patient?

Correct Answer: B

Rationale: Levetiracetam treats focal complex partial seizures by modulating synaptic vesicle protein SV2A, reducing excitability with broad efficacy, good tolerability, and minimal interactions, making it an appropriate initial therapy. Ethosuximide targets absence seizures, not focal. Diazepam manages acute seizures, not maintenance. Carbamazepine plus primidone is excessive; carbamazepine alone controls focal seizures via sodium channel blockade but has more interactions. Watchful waiting risks progression. Levetiracetam's profile, per guidelines, suits this patient as a first-line choice.

Correct Answer: C

Rationale: Anatomy, physiology, and microbiology provide foundational knowledge for pharmacology, enabling nurses to understand drug actions, interactions, and patient responses, ultimately enhancing patient care through informed medication administration. Pharmacology as an outgrowth oversimplifies its integration with these sciences. Curriculum mandates explain requirements but not their value. Understanding these subjects is essential, yet the broader goal is applying this to care, not just comprehension. Linking them to patient outcomes-like knowing how antibiotics target bacteria (microbiology) or how drugs affect organs (anatomy/physiology)-grounds pharmacology in practical, holistic nursing practice, making it the strongest rationale.

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: A

Rationale: In hypovolemic shock due to significant blood loss, the primary goal is to quickly restore the lost volume of red blood cells to improve tissue perfusion and oxygen delivery. Packed Red Blood Cells (PRBCs) are the most appropriate blood product for this situation as they contain a high concentration of red blood cells and minimal plasma, making them the most efficient way to replace lost red blood cells. Whole blood, Cryoprecipitate, and Fresh Frozen Plasma (FFP) contain other blood components which are not the immediate priority in this scenario.

Correct Answer: D

Rationale: At high doses, aspirin shifts to zero-order kinetics, not first-order, due to saturated metabolism, so that's false. Aspirin irreversibly inhibits COX, not reversibly, distinguishing it from other NSAIDs, making that false. At low doses (≤2 g/day), aspirin retains uric acid, not reduces it (uricosuric at >4 g/day), so that's incorrect. All NSAIDs, including aspirin and ibuprofen, distribute into synovial fluid with repeated dosing, a true statement, aiding arthritis treatment. Combining ibuprofen and aspirin reduces, not increases, efficacy due to competition. Synovial penetration is key to their anti-inflammatory action in joints.