A patient diagnosed with alcoholism has questions about his medications. The nurse correctly explains that alcoholism can be associated with deficiency of which vitamin?

Correct Answer: B

Rationale: Alcoholism is commonly associated with deficiencies in B-complex vitamins, particularly thiamine (B1), due to poor dietary intake and impaired absorption. Vitamin A (A), vitamin D (C), and vitamin K (D) deficiencies are less commonly linked to alcoholism.

Correct Answer: D

Rationale: Isoniazid undergoes phase II acetylation via hepatic N-acetyltransferases, and the rate of metabolism can vary between slow and fast acetylators.

Correct Answer: D

Rationale: Systolic hypertension (168 mmHg) in the elderly increases cardiovascular risk, despite normal diastolic (80 mmHg). Echo isn't first-line without organ damage signs (normal ECG). Reassurance ignores systolic risk; treatment is indicated (>160 mmHg). Doxazosin, an alpha-blocker, is less preferred initially due to hypotension risk. Ramipril, an ACE inhibitor, is effective, but amlodipine, a calcium channel blocker, is most appropriate per guidelines (e.g., NICE) for isolated systolic hypertension in the elderly, offering vascular protection and tolerability. Its efficacy reduces stroke and MI risk, critical at this age.

Correct Answer: A

Rationale: Furosemide, a loop diuretic, can rarely lead to a serious adverse reaction known as Stevens-Johnson syndrome. Stevens-Johnson syndrome is a severe skin reaction that can be life-threatening and typically involves painful blistering and shedding of the skin. This reaction is considered a serious medical emergency and requires immediate medical attention. It is crucial to monitor for any signs of skin changes or reactions while using Furosemide and report them to a healthcare provider promptly.

Correct Answer: C

Rationale: The therapeutic range for Lithium is typically considered to be 0.6-1.2 mEq/L for maintenance treatment. However, some sources may also suggest a wider therapeutic range of 0.5-2 mEq/L. Monitoring serum lithium levels is crucial to ensure that the patient is within the therapeutic range and to adjust the dosage accordingly to avoid toxicity or subtherapeutic levels. Thus, option C (0.5-2) provides a more comprehensive and inclusive range that is commonly referenced in clinical practice.

Correct Answer: D

Rationale: The correct statement by the nurse is D. "Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes." This instruction is important for patients taking furosemide (Lasix) because this medication can cause changes in blood pressure, especially when changing positions quickly. By rising slowly, the patient can minimize the risk of dizziness or fainting. This precaution is crucial to ensure patient safety while taking furosemide.

Correct Answer: B

Rationale: Atropine, a muscarinic antagonist, is used in oral surgery to manage parasympathetic effects. Option , gastrointestinal relaxation, is a minor effect but not the primary goal in wisdom tooth extraction. Option , drying oral mucous membranes, is correct-by inhibiting salivary glands, atropine reduces secretions, keeping the surgical field clear, a key benefit in oral procedures. Option , inducing tachycardia, occurs but isn't the intent; low doses minimize this. Option , pupillary dilation, happens but is irrelevant to oral surgery. Option (E), reducing urinary motility, is incidental. The drying effect directly aids visibility and cleanliness during surgery, aligning with clinical practice. At low doses, atropine selectively targets salivary inhibition over systemic effects, making it practical and effective. This rationale reflects its established use in anesthesia to optimize surgical conditions without unnecessary cardiovascular or ocular complications.

Correct Answer: B

Rationale: Alcohol withdrawal in a chronic alcoholic (300 mg/dL) requires lorazepam . This benzodiazepine mimics alcohol's GABA enhancement, preventing seizures and agitation. Buspirone treats anxiety, not withdrawal. Pentobarbital is excessive. Phenytoin targets seizures alone. Saline (E) supports but doesn't treat. Lorazepam's safety is key.

Correct Answer: A

Rationale: Combination chemotherapy is used to target cancer cells through multiple mechanisms, reducing the likelihood of resistance. Single-agent therapy often leads to the development of resistant cell lines, as cancer cells can adapt to the drug. By using a combination of drugs with different mechanisms of action, the treatment can more effectively kill cancer cells and prevent resistance. While two drugs may increase efficacy, the primary rationale is to overcome resistance. Larger doses of single agents are not the main reason for combination therapy.