A 77-year-old man who has been diagnosed with an upper respiratory tract infection tells the nurse that he is allergic to penicillin. Which is the most appropriate response by the nurse?

Correct Answer: C

Rationale: When a patient reports a drug allergy, it is essential for the nurse to gather specific information about the nature of the reaction. Asking, 'What type of reaction did you have when you took penicillin?' allows the nurse to determine whether the reaction was a true allergy (e.g., anaphylaxis) or a side effect (e.g., gastrointestinal upset). This information is critical for guiding treatment decisions and avoiding potentially life-threatening situations. Dismissing the allergy or making assumptions about its relevance based on the patient's age is inappropriate and could compromise patient safety. Therefore, the nurse's priority is to assess the details of the allergic reaction.

Correct Answer: A

Rationale: Renal failure alters drug clearance, requiring dose adjustments or avoidance. Prednisolone, a glucocorticoid, is metabolized hepatically to prednisone, with minimal renal excretion, making it safe without adjustment in renal failure. Netilmicin, an aminoglycoside, is renally cleared, risking ototoxicity if not reduced. Metformin, cleared renally, risks lactic acidosis in renal impairment, often avoided. Methotrexate, renally excreted, accumulates in failure, causing toxicity (e.g., marrow suppression). Tinzaparin, a low molecular weight heparin, requires adjustment due to renal clearance. Prednisolone's hepatic handling makes it the exception, safe for use in renal dysfunction without modification.

Correct Answer: B

Rationale: Amiodarone is a class III antiarrhythmic that affects sodium (Na+), potassium (K+), and calcium (Ca2+) channels, prolonging repolarization, so the statement excluding Ca2+ effects is false. It has antianginal effects by reducing myocardial oxygen demand through heart rate and afterload reduction, a true statement and its correct attribute. Its half-life is exceptionally long (weeks to months), not short, due to extensive tissue distribution, making that false. It decreases, not increases, peripheral resistance via vasodilation, so that's incorrect. It also affects the lungs, causing potential pulmonary toxicity, not minimal impact. The antianginal property is key to its use in angina alongside arrhythmias, reflecting its broad ion channel blockade and hemodynamic benefits, necessitating careful monitoring for side effects.

Correct Answer: A

Rationale: Anabolic steroids, synthetic testosterone derivatives, suppress natural hormone production, including spermatogenesis, leading to infertility-a critical risk for young athletes to understand. They also impact the entire body, notably causing liver damage (e.g., hepatotoxicity or tumors), a systemic effect worth noting. However, while effective for muscle growth, weight training surpasses steroids in safety and sustainability, debunking the ‘most effective' claim. Aggression, or ‘roid rage,' is a well-documented behavioral change due to hormonal imbalance, making it another key point. Infertility stands out in education, as it's a direct, long-term consequence tied to reproductive health, resonating with teens' future planning, and is supported by evidence of testicular atrophy and reduced sperm count, distinguishing it from broader effects or myths about efficacy.

Correct Answer: C

Rationale: Aspirin overdose, an acidic drug, causes metabolic acidosis; sodium bicarbonate alkalinizes urine, enhancing excretion by ionizing aspirin, reducing toxicity. IV fluids support hydration but don't target pH. Ammonium chloride acidifies, worsening acidosis. Proteins don't bind aspirin effectively in this context-albumin's role is minimal. Bicarbonate addresses salicylate poisoning directly, a standard emergency approach.