A client with a history of angina pectoris reports chest pain while ambulating in the corridor. What should the nurse do first?

Correct Answer: B

Rationale: When a client with a history of angina pectoris experiences chest pain while ambulating, the priority action for the nurse is to assist the client to sit or lie down. This helps reduce the demand on the heart by decreasing physical exertion. Checking vital signs, administering medication, or applying oxygen can follow once the client is in a more comfortable position. Checking vital signs (Choice A) may be important but addressing the immediate discomfort by positioning the client comfortably takes precedence. Administering sublingual nitroglycerin (Choice C) is appropriate but should come after ensuring the client's comfort. Applying nasal oxygen (Choice D) can be beneficial, but it should not be the first action; assisting the client to sit or lie down is the initial priority.

Correct Answer: B

Rationale: Choice B is correct because men's greater lean mass dilutes water-soluble drugs, often requiring higher doses for efficacy, unlike others. Choice A is incorrect as lipid-soluble drugs align with fat, lower in men. Choice C is wrong because protein binding isn't sex-specific here. Choice D is incorrect since only water-soluble drugs apply.

Correct Answer: B

Rationale: Choice B is correct because dosing cephalexin every 8 hours aligns with its biological half-life, the time it takes for half the drug to be eliminated, ensuring steady therapeutic levels. Choice A is incorrect as ‘propensity to target receptor' isn't a standard pharmacokinetic term for dosing decisions. Choice C is wrong because pharmacodynamics (drug effects) informs efficacy, not timing. Choice D is incorrect since safety and side effects influence drug choice, not specifically the 8-hour interval.

Correct Answer: C

Rationale: Choice C is correct because CYP 3A4 drugs can induce (speed up) or inhibit (slow down) metabolism of other drugs sharing this pathway, affecting their levels and efficacy. Choice A is incorrect as it's only half the story—induction happens, but inhibition does too. Choice B is wrong because it misses induction potential. Choice D is incorrect since both effects are well-documented with CYP 3A4.

Correct Answer: A

Rationale: Choice A is correct because estrogen counteracts testosterone's masculinizing effects in transgender men, conflicting with therapy aims, so it's avoided. Choice B is incorrect as alpha blockers don't interfere with testosterone goals. Choice C is wrong because beta blockers are unrelated to therapy effects. Choice D is incorrect since only estrogen applies.

Correct Answer: B

Rationale: Choice B is correct because phenytoin has a narrow therapeutic index, requiring monitoring of peak and trough levels to ensure efficacy and avoid toxicity, unlike broader-range drugs. Choice A is incorrect as acetaminophen's wide safety margin and short-term use don't typically need monitoring. Choice C is wrong because albuterol's inhaled route and rapid action don't require blood level checks. Choice D is incorrect since only phenytoin fits the monitoring profile.

Correct Answer: A

Rationale: Bradycardia is a significant side effect of propranolol, a beta-blocker that slows the heart rate. It indicates potential cardiovascular complications and should be reported promptly to the healthcare provider for further evaluation and management. Dry mouth, constipation, and increased appetite are common side effects of various medications but are not directly associated with propranolol's mechanism of action.

Correct Answer: B

Rationale: The correct answer is B. Using an electric razor is advised to prevent cuts, which is crucial for individuals taking warfarin due to the increased risk of bleeding associated with this medication. Lifestyle changes related to warfarin therapy focus on minimizing the risk of bleeding, and using safety measures such as an electric razor is a practical recommendation to reduce the likelihood of injury. Choices A, C, and D are incorrect. Avoiding prolonged sitting or standing is more related to preventing blood clots than to the bleeding risk of warfarin. Taking warfarin with a full glass of water is not a specific lifestyle change associated with its use. Eating a diet low in protein is not a typical recommendation for individuals on warfarin therapy.

Correct Answer: C

Rationale: Choice C is correct because grapefruit juice inhibits CYP3A4, which metabolizes simvastatin, increasing drug levels and rhabdomyolysis risk, so it's to be avoided. Choice A is incorrect as milk doesn't affect simvastatin significantly. Choice B is wrong because orange juice has no notable interaction. Choice D is incorrect since green leafy vegetables don't impact simvastatin metabolism.