A patient diagnosed with malignant melanoma, a skin cancer, is treated with interferon alfa-2a. The nurse teaches this patient about which side effect?

Correct Answer: C

Rationale: Flulike syndrome, characterized by fever, chills, fatigue, and muscle aches, is a common side effect of interferon alfa-2a. This occurs because the drug stimulates the immune system, mimicking the body's response to a viral infection. While gastrointestinal symptoms may occur, they are less common than flulike syndrome. Interferon alfa-2a does not typically cause an increase in white or red blood cells. The nurse should educate the patient about managing flulike symptoms, such as using antipyretics and staying hydrated.

Correct Answer: C

Rationale: Phenytoin exhibits non-linear kinetics because its elimination pathways become saturated at therapeutic doses, leading to a disproportionate rise in plasma levels with dose increases.

Correct Answer: C

Rationale: Glyceryl trinitrate (GTN) relieves effort angina primarily by reducing preload (venodilation) and afterload (arterial dilation), decreasing myocardial oxygen demand, a true and major mechanism. It doesn't primarily reduce coronary vasospasm (more relevant in variant angina), nor significantly affect the renin-angiotensin system in this context. While it causes some coronary vasodilation, this is secondary to systemic effects on demand reduction. It doesn't cause systemic vasoconstriction (opposite effect). The preload/afterload reduction is the cornerstone of GTN's efficacy in stable angina, improving oxygen supply-demand balance, a critical concept in ischemic heart disease management.

Correct Answer: B

Rationale: Oral decongestants (e.g., pseudoephedrine) act systemically, vasoconstricting vessels beyond the nose, causing effects like hypertension , unlike intranasal decongestants (e.g., oxymetazoline), which are localized but risk rebound congestion. Oral efficacy isn't inherently superior; it's slower. Rebound is nasal-specific. High efficacy is vague. Choice B highlights systemic impact, a key distinction nurses must recognize for safe administration.

Correct Answer: B

Rationale: Lithium levels rise with drugs reducing renal clearance or altering metabolism. St John's wort induces CYP enzymes, potentially lowering lithium (not renally metabolized). Ibuprofen, an NSAID, reduces renal lithium excretion by inhibiting prostaglandins, increasing plasma levels, a well-known interaction. Phenytoin induces metabolism but doesn't affect lithium's renal clearance. Haloperidol and sertraline have minimal pharmacokinetic impact on lithium. Ibuprofen's effect necessitates monitoring, as elevated lithium risks toxicity (e.g., tremor, confusion), critical in bipolar management.