A nurse is providing discharge instructions to a patient who is taking atenolol (Tenormin) to treat hypertension. What would the nurse teach the patient regarding a possible drug-drug interaction?

Correct Answer: C

Rationale: A decreased hypertensive effect can occur if a beta-selective adrenergic blocking agent is used in combination with NSAIDs. If this combination is used, the patient should be monitored closely and dosage adjustments made. Antibiotics, oral contraceptives, and antifungal agents are not known to have a drug-drug interaction. The nurse should educate the patient about potential interactions and advise them to consult their healthcare provider before starting any new medications.

Correct Answer: B

Rationale: Intravesical administration involves the direct instillation of medication into the bladder, which is a common method for treating superficial bladder cancer. This approach allows high concentrations of the drug, such as mitomycin, to come into direct contact with the cancerous cells lining the bladder, minimizing systemic side effects. Intraventricular and intrathecal administrations are used for delivering drugs to the brain and spinal cord, respectively, while intravascular administration refers to intravenous delivery. Intravesical administration is specifically designed for bladder conditions, making it the correct answer.

Correct Answer: B

Rationale: Chemotherapy can cause anemia, which reduces the oxygen-carrying capacity of the blood due to decreased red blood cells or hemoglobin. For a patient with a history of cardiac disease, this is particularly concerning because the heart must work harder to deliver oxygen to tissues, potentially exacerbating cardiac conditions. Reduced white blood cells increase infection risk, but this does not directly affect cardiac function. Sodium levels and hematocrit are not the primary concerns in this context. Therefore, reduced oxygen-carrying capacity is the correct answer.

Correct Answer: B

Rationale: Converting atrial fibrillation (AF) to sinus rhythm requires cardioversion or antiarrhythmics. Digoxin controls rate, not rhythm, ineffective for conversion. Atenolol, a beta-blocker, and diltiazem, a calcium channel blocker, manage rate, not rhythm restoration. Lidocaine treats ventricular arrhythmias. Amiodarone, a class III antiarrhythmic, prolongs repolarization, effectively converting AF to sinus rhythm, especially in acute settings, outperforming others. Its broad-spectrum action is key in AF management, balancing efficacy and safety.

Correct Answer: C

Rationale: Nitrous oxide has a high minimum alveolar concentration (MAC >100%), not low, due to low potency, so that's false. Halogenated agents (e.g., isoflurane) have higher brain:blood coefficients, reflecting solubility, making that false. They reduce mean arterial pressure (MAP) proportional to alveolar concentration via vasodilation, a true statement. Nitrous oxide does decrease tidal volume and increase respiratory rate, true. They don't reduce cerebral metabolic rate via blood flow alone but directly. MAP reduction is a key hemodynamic effect, guiding anesthetic depth monitoring.