A 62-year-old man is to receive lidocaine as treatment for a symptomatic dysrhythmia. Upon assessment, the nurse notes that he has a history of alcoholism and has late-stage liver failure. The nurse will expect which adjustments to his drug therapy?

Correct Answer: A

Rationale: The correct answer is A: The dosage will be reduced by 50%. In this case, the patient has late-stage liver failure, which can impair the metabolism and clearance of lidocaine. Since lidocaine is metabolized in the liver, reducing the dosage by 50% will prevent potential toxicity due to impaired liver function. Incorrect Choices: B: Adding a diuretic to lidocaine is not indicated in this scenario as it does not address the issue of impaired liver function affecting lidocaine metabolism. C: Changing lidocaine to an oral dosage form does not address the issue of impaired liver function and may still lead to toxicity due to altered metabolism. D: Increasing the dosage of lidocaine would only increase the risk of toxicity in a patient with impaired liver function. It is important to reduce the dosage to prevent adverse effects.

Correct Answer: C

Rationale: The correct answer is C because inhalation actually provides rapid access to the general circulation due to the large surface area and rich blood supply in the lungs. A is correct as intravenous administration is the fastest route. B is correct as intramuscular administration necessitates a sterile technique to prevent infection. D is correct as subcutaneous administration can cause local irritation due to the injection site. Thus, C is the incorrect statement as inhalation does not provide slow access to the general circulation.

Correct Answer: C

Rationale: Tolerance develops due to the body adapting to a drug's presence, requiring higher doses for the same effect. Diminished absorption means less drug enters the body, leading to tolerance. Rapid excretion removes the drug quickly, causing the body to adjust, also leading to tolerance. Therefore, both factors contribute to tolerance development. Choice C is correct. Choices A and B alone do not fully explain tolerance development as they are only partial explanations, making them incorrect.

Correct Answer: B

Rationale: The correct answer is B: Cardiovascular collapse. Universal anesthetic refers to a local anesthetic that can potentially affect all systems, including the cardiovascular system, leading to cardiovascular collapse. This answer is correct as it aligns with the term "universal anesthetic." Choices A, C, and D are incorrect as they do not specifically relate to the concept of a universal anesthetic. Seizures and respiratory failure are not exclusive to a universal anesthetic, and D, "All of the above," is incorrect as it includes options that are not directly related to the term "universal anesthetic."

Correct Answer: A

Rationale: The correct answer is A: Pancuronium. It is a nondepolarizing muscle relaxant that works by blocking acetylcholine receptors at the neuromuscular junction, leading to muscle relaxation. Succinylcholine (B) is a depolarizing muscle relaxant that causes initial muscle depolarization before relaxation. Hexamethonium (C) is a ganglionic blocking agent used for hypertension. Scopolamine (D) is an anticholinergic drug used for motion sickness. Thus, the correct choice is A as it specifically acts as a nondepolarizing muscle relaxant by blocking acetylcholine receptors.