A client is taking a medication that is metabolized by the CYP enzymes. Which medication inhibits several of the CYP enzymes?

Correct Answer: C

Rationale: The correct answer is Cimetidine (C) because it is a known inhibitor of several CYP enzymes. Cimetidine can inhibit CYP1A2, CYP2C9, CYP2D6, and CYP3A4, among others. This can lead to potential drug interactions and altered metabolism of medications that are substrates of these enzymes. A: Cisplatin does not inhibit CYP enzymes. B: Acebutolol hydrochloride is primarily metabolized by CYP2D6, but it does not inhibit CYP enzymes. D: Dicloxacillin sodium is not known to inhibit CYP enzymes. In summary, Cimetidine is the correct answer as it inhibits several CYP enzymes, while the other choices do not possess this inhibitory effect.

Correct Answer: B

Rationale: The correct answer is B: The combined effects are greater than the effects of either one of the drugs alone. When two medications are administered simultaneously, they may work synergistically to produce a greater therapeutic effect than each drug would achieve individually. This is known as a therapeutic synergy. By combining the actions of the drugs, the overall treatment outcome can be more effective. Incorrect choices: A: The adverse effects of one of the drugs are nullified by the other drug - This is incorrect because therapeutic outcomes focus on positive effects, not negating adverse effects. C: One of the drugs enhances metabolism, while the other drug enhances either distribution or absorption - This is incorrect as it does not address the overall therapeutic outcome of the combination. D: Both drugs are toxic in isolation but therapeutic when administered together - This is incorrect as therapeutic outcomes aim for positive effects, not relying on toxicity for efficacy.

Correct Answer: B

Rationale: The correct answer is B. Regular monitoring of the client's serum lithium levels is crucial to ensure that the drug levels are within a therapeutic range (not too low or too high) to effectively manage bipolar disorder. Maintaining therapeutic levels helps prevent relapse of symptoms and minimizes the risk of toxicity. Monitoring also allows for adjustments in dosage if needed. Choice A is incorrect because blood-drug incompatibilities are not the primary reason for monitoring lithium levels. Choice C is incorrect because monitoring lithium levels is not to determine the need for additional medications. Choice D is incorrect because monitoring is not primarily to confirm adherence, although it can provide information on compliance.

Correct Answer: C

Rationale: Rationale for Correct Answer C: 1. Albumin is a major plasma protein that binds to drugs. 2. Hypoalbuminemia means less albumin is available to bind drugs. 3. Less albumin results in more free drug in the bloodstream. 4. Free drug is pharmacologically active and can generate effects. 5. Therefore, with less albumin, less free drug is available to generate an effect. Summary: A: Distribution of drugs may be affected by protein binding, not albumin levels. B: Solubility matching absorption sites is more related to drug formulation. D: Albumin-bound drugs are not readily excreted by the kidney; they are protected from filtration.

Correct Answer: C

Rationale: The correct answer is C because storage reservoirs increase the length of time a drug is available and active in the body. By administering medroxyprogesterone IM, a storage reservoir is created in the muscle tissue, allowing for a slow and sustained release of the drug over time. This helps maintain therapeutic levels of the medication in the bloodstream, prolonging its effects. Incorrect answers: A: Assuring the drug reaches its intended target tissue is related to factors such as drug transport mechanisms, not storage reservoirs. B: Loading doses are given to achieve therapeutic levels quickly, not necessarily due to storage reservoirs. D: Storage reservoirs are not limited to collagen tissues; they can be present in various tissues depending on the drug's properties.