A hospital nurse is taking imipramine for a phobic anxiety disorder, and her patient is being treated with chlorpromazine for a psychotic disorder. Which of the following adverse effects is likely to occur in both of these individuals?

Correct Answer: C

Rationale: Imipramine (TCA) and chlorpromazine (antipsychotic) share anticholinergic and alpha-adrenergic blocking properties. Orthostatic hypotension arises from alpha-1 receptor blockade, causing vasodilation and blood pressure drops upon standing, a common effect in both drugs, impacting patients and users alike. Excessive salivation and pupillary constriction (miosis) are cholinergic effects, opposite to their anticholinergic actions (dry mouth, mydriasis). Seizure threshold decreases with both, but this isn't an ‘adverse effect' per se—it's a risk. Weight loss isn't typical; TCAs and antipsychotics often cause gain. The shared alpha-blockade mechanism makes orthostatic hypotension a frequent, clinically significant side effect in both individuals, requiring caution in mobility and monitoring.

Correct Answer: C

Rationale: Salicylamide is less effective than aspirin but may be used in patients allergic to aspirin. It is a derivative of salicylic acid and acts as an analgesic and antipyretic, but it lacks the anti-inflammatory properties of aspirin. Sodium salicylate and acetylsalicylic acid (aspirin) are more effective than salicylamide. Methyl salicylate is mainly used as a topical analgesic. Diflunisal is a salicylate derivative that is more potent and has a longer duration of action compared to aspirin, so it is not a suitable alternative for patients allergic to aspirin.

Correct Answer: A

Rationale: Explaining a diuretic's role in reducing fluid for hypertension is appropriate education, informing the client about its purpose in a clear, relevant way. Mechanism (e.g., sodium excretion) wasn't detailed-purpose was. Prototype drugs weren't specified, and consequences of non-use weren't covered. Appropriate education fits, enhancing adherence by linking the drug to the condition, a practical teaching goal.

Correct Answer: C

Rationale: The five rights of medication administration are: the right patient, the right drug, the right dose, the right route, and the right time. These are essential principles to ensure safe and effective medication administration. The attitude of the healthcare provider is important for delivering care, but it is not included as one of the fundamental rights of medication administration. It is important for healthcare providers to approach medication administration with professionalism, compassion, and attentiveness, but it is not considered one of the primary rights in the context of medication administration protocols.

Correct Answer: D

Rationale: Metformin is contraindicated in severe renal failure due to the risk of lactic acidosis, a rare but potentially fatal side effect.