A patient developed hives and itching after receiving a drug for the first time. Which instruction by the nurse is accurate?

Correct Answer: A

Rationale: Step-by-step rationale for why choice A is correct: 1. Stopping the medication is crucial to prevent further allergic reactions. 2. Encouraging the patient to wear a medical alert bracelet will help healthcare providers quickly identify the allergy. 3. This action promotes patient safety and prevents future adverse reactions. Summary of why the other choices are incorrect: B: Anaphylactic reactions are severe and life-threatening, and hives and itching do not necessarily indicate an anaphylactic reaction. C: Lowering the dosage is not the appropriate response to an allergic reaction; stopping the medication is necessary. D: It is not safe to assume that the reaction was mild, as allergic reactions can escalate upon subsequent exposures.

Correct Answer: B

Rationale: The correct answer is B: Pore formation in fungal cell membrane. Amphotericin B is a polyene antifungal medication that works by binding to ergosterol in the fungal cell membrane, leading to the formation of pores. This disrupts membrane integrity, causing leakage of intracellular components and ultimately cell death. This mechanism of action is specific to fungal cells, as mammalian cells contain cholesterol instead of ergosterol. Choice A is incorrect because amphotericin B does not activate fungal cytochrome P-450 enzymes; instead, it disrupts the fungal cell membrane. Choice C is incorrect because amphotericin B does not inhibit fungal cytochrome P-450 enzymes. Choice D is incorrect because amphotericin B does not inhibit fungal mitosis; its primary mechanism of action is through membrane disruption.

Correct Answer: C

Rationale: The correct answer is C: Stratum corneum. The drug most likely acted on the outermost layer of the skin, the stratum corneum, as it is responsible for drug absorption and penetration. The other layers (A, B, D) are deeper layers of the skin and are not primarily involved in drug action. The stratum basale (A) is the innermost layer responsible for cell division, the stratum spinosum (B) provides strength and flexibility, and the pigment layer (D) contains melanocytes responsible for skin color. Therefore, the stratum corneum is the most likely site for drug action due to its role in drug absorption and penetration.

Correct Answer: B

Rationale: The correct answer is B: Albuterol. Albuterol is a bronchodilator that works by relaxing bronchial muscles, making it easier to breathe. It is commonly prescribed for the treatment of asthma to provide quick relief of symptoms. Prednisone (A) is a corticosteroid used for long-term control of asthma but does not directly relax bronchial muscles. Ipratropium (C) is an anticholinergic medication that helps open the airways but does not primarily target bronchial muscle relaxation. Methotrexate (D) is an immunosuppressant used for conditions like rheumatoid arthritis, not for asthma treatment.

Correct Answer: B

Rationale: The correct answer is B: Activating peroxisome proliferator-activated receptor alpha (PPAR-alpha). Fenofibrate is a fibrate medication that works by activating PPAR-alpha receptors. PPAR-alpha activation leads to increased expression of genes involved in lipid metabolism, resulting in decreased triglyceride levels and increased HDL cholesterol levels. This mechanism of action is specific to fenofibrate and other fibrates. Now, let's analyze why the other choices are incorrect: A: Inhibiting HMG-CoA reductase in the liver - This is the mechanism of action of statins, not fibrates like fenofibrate. C: Blocking calcium channels in the blood vessels - This is unrelated to the mechanism of action of fenofibrate and is more commonly associated with calcium channel blockers used in hypertension management. D: Increasing the absorption of cholesterol in the intestines - This is the mechanism of action of bile acid sequestrants, not fibrates like fenofibrate