A male patient is to begin therapy with isotretinoin and asks, 'What do I have to remember to do while taking this medicine?' How would the nurse respond? (Select all that apply.)

Correct Answer: B

Rationale: Isotretinoin is a potent medication with significant side effects and precautions. Patients should avoid sunlight (A) due to increased photosensitivity. Regular laboratory tests (C) are necessary to monitor liver function and lipid levels. Two forms of contraceptives (D) are required for females due to the high risk of teratogenicity. Monitoring weight (B) is not typically associated with isotretinoin use.

Correct Answer: B

Rationale: Graft-versus-host disease (GVHD) is a potential complication in immunocompromised patients after receiving blood transfusions. It occurs when donor lymphocytes attack the recipient's tissues, leading to symptoms such as fever, rash, liver dysfunction, and diarrhea. This condition typically arises weeks to months after transfusion. An allergic response to medication would not explain the systemic symptoms. Myelosuppression is unrelated to transfusion. Therefore, GVHD is the most likely diagnosis in this scenario.

Correct Answer: C

Rationale: Acute porphyria involves heme synthesis defects, triggered by drugs inducing hepatic enzymes (e.g., CYP450). Quinine, used in malaria, isn't a major porphyria trigger. Atenolol, a beta-blocker, is porphyrin-safe, with minimal enzyme induction. Oral contraceptives, containing estrogens/progestins, induce ALA synthase, exacerbating acute porphyria, making them contraindicated. Heparin and amoxicillin don't significantly affect porphyrin metabolism. The contraceptive link reflects hormonal exacerbation of porphyric attacks, critical for safe prescribing in this rare condition.

Correct Answer: A

Rationale: Atropine, a muscarinic antagonist, causes bronchodilation by relaxing bronchial smooth muscle, a true statement used in asthma or COPD. It produces mydriasis (pupil dilation), not miosis (constriction), making that false, as it blocks parasympathetic tone. It's highly lipid-soluble, crossing the blood-brain barrier, so that's false. It doesn't block acetylcholine (ACh) reuptake (there's no such mechanism) but competitively inhibits muscarinic receptors, so that's incorrect. It reduces, not increases, salivary secretions. Bronchodilation is a primary therapeutic effect, reflecting atropine's anticholinergic action, critical for respiratory applications and distinguishing it from sympathomimetics.

Correct Answer: D

Rationale: Luteinizing hormone (LH), from the pituitary, stimulates Leydig cells in the testes to produce testosterone, the primary male sex hormone, making its regulation LH's chief role in men. Sperm production is driven by follicle-stimulating hormone (FSH), not LH, though both support fertility. Secondary sex characteristics, like body hair, depend on testosterone, which LH indirectly influences by controlling its synthesis, not directly regulating the traits. Growth of male sex organs relies on androgens, again tied to testosterone, not LH's direct action. Testosterone regulation is LH's specific function, as it triggers the steroidogenesis pathway, critical for male physiology, distinguishing it from FSH's gamete focus and underscoring its hormonal primacy in this context.