A 52-year-old man with asthma treated with a β2 agonist via inhaler has been having difficulty with therapy because of persistent changes in blood pressure, nausea, vomiting, and hypomagnesemia. Which of the following medications would be best for this patient?

Correct Answer: D

Rationale: β2-agonist side effects (BP changes, nausea, hypomagnesemia) suggest overuse. Ipratropium , an anticholinergic bronchodilator, avoids these. Options , , persist with β2-agonists, risking side effects. Epinephrine (E) worsens them. Ipratropium's different mechanism improves asthma control safely.

Correct Answer: D

Rationale: Angiotensin-converting enzyme (ACE) inhibitors, a type of angiotensin inhibitor, may have a serious interaction with nonsteroidal anti-inflammatory drugs (NSAIDs). When used together, they may reduce the effectiveness of the ACE inhibitor in lowering blood pressure and could potentially lead to decreased kidney function. It is important for the nurse to be aware of this interaction and monitor the patient closely for any adverse effects when these medications are used concurrently.

Correct Answer: B

Rationale: Naloxone is the appropriate medication to be administered to a patient with a suspected opioid overdose. Naloxone is an opioid receptor antagonist, meaning it can quickly reverse the effects of opioids on the central nervous system. It works by binding to the same receptors in the brain that opioids target, blocking their effects and rapidly restoring normal respiration and consciousness in a person who has overdosed on opioids. This can be a life-saving treatment for opioid overdose patients. Exenatide, Heparin, and Tolvaptan are not appropriate medications for reversing opioid overdose.

Correct Answer: B

Rationale: Atropine, a muscarinic antagonist, is used in oral surgery to manage parasympathetic effects. Option , gastrointestinal relaxation, is a minor effect but not the primary goal in wisdom tooth extraction. Option , drying oral mucous membranes, is correct-by inhibiting salivary glands, atropine reduces secretions, keeping the surgical field clear, a key benefit in oral procedures. Option , inducing tachycardia, occurs but isn't the intent; low doses minimize this. Option , pupillary dilation, happens but is irrelevant to oral surgery. Option (E), reducing urinary motility, is incidental. The drying effect directly aids visibility and cleanliness during surgery, aligning with clinical practice. At low doses, atropine selectively targets salivary inhibition over systemic effects, making it practical and effective. This rationale reflects its established use in anesthesia to optimize surgical conditions without unnecessary cardiovascular or ocular complications.

Correct Answer: B

Rationale: The therapeutic range for phenytoin (Dilantin) is typically 10-20 mcg/mL. A level of 18 mcg/mL is at the upper end of the therapeutic range, and the patient may be at risk for toxicity, especially if symptoms are present. Therefore, the nurse should contact the provider to discuss potentially decreasing the phenytoin dose to avoid toxicity. Monitoring levels closely and reporting any signs of toxicity are also important actions, but the immediate action should be to address the potential for toxicity by discussing a dosage adjustment with the provider.

Correct Answer: D

Rationale: Administration of leucovorin in the context of methotrexate treatment is known as rescue therapy. Leucovorin is used as a rescue agent to reduce the toxicity of methotrexate on normal cells. By providing leucovorin, which is a fully activated form of folic acid, the body can bypass the inhibition caused by methotrexate and continue with DNA base synthesis. This helps protect healthy cells and tissues from the toxic effects of methotrexate while allowing the chemotherapy to target and kill cancer cells. Rescue therapy with leucovorin is typically timed to occur after methotrexate administration to maximize its protective effects on normal cells.

Correct Answer: C

Rationale: Redness and pain at the site of the infusion are important signs of a potential infiltration or extravasation of the medication, in this case pentamidine (Pentam) IV. Pentamidine is an antimicrobial medication used to treat and prevent Pneumocystis jiroveci pneumonia (PCP) in patients who are immunocompromised, such as those with HIV. Infiltration or extravasation of IV medications can lead to significant tissue damage, necrosis, and other complications. Therefore, it is crucial to immediately address any signs of redness and pain at the infusion site to prevent further harm to the patient. This assessment finding should be promptly relayed to the physician for appropriate management, which may include discontinuation of the infusion, monitoring for complications, and providing alternative treatments if necessary. The other assessment findings (blood pressure of 100/62 mm/Hg

Correct Answer: A

Rationale: Combination chemotherapy is used to target cancer cells through multiple mechanisms, reducing the likelihood of resistance. Single-agent therapy often leads to the development of resistant cell lines, as cancer cells can adapt to the drug. By using a combination of drugs with different mechanisms of action, the treatment can more effectively kill cancer cells and prevent resistance. While two drugs may increase efficacy, the primary rationale is to overcome resistance. Larger doses of single agents are not the main reason for combination therapy.

Correct Answer: D

Rationale: β2-agonist side effects (BP changes, nausea, hypomagnesemia) suggest overuse. Ipratropium , an anticholinergic bronchodilator, avoids these. Options , , persist with β2-agonists, risking side effects. Epinephrine (E) worsens them. Ipratropium's different mechanism improves asthma control safely.