A patient has been changed from a first generation H1 receptor antagonist to a second generation H1 receptor antagonist. The nurse evaluates that the patient understands the benefit of this change when which statement is made?

Correct Answer: D

Rationale: Second-generation antihistamines reduce sedation , a key benefit over first-generation. Alcohol , dry mouth , and urination aren't primary differences. D shows understanding, making it the best statement.

Correct Answer: B

Rationale: Ethanol competes with methanol metabolism, not enhances it, increasing toxicity, so that's false. Grapefruit juice inhibits CYP3A4, reducing cyclosporin metabolism, raising levels, a true statement critical for transplant patients. Phenytoin induces, not inhibits, theophylline metabolism, lowering levels. Rifampicin induces, not inhibits, oral contraceptive metabolism, reducing efficacy. Griseofulvin induces warfarin metabolism, not inhibits. Grapefruit juice's effect is a classic drug-food interaction, necessitating dose adjustments or avoidance.

Correct Answer: C

Rationale: Lorazepam is a benzodiazepine commonly used as a preanesthetic medication due to its anxiolytic and sedative properties. In patients undergoing liver transplantation, where hepatic function is compromised, drugs that rely on liver metabolism could accumulate and cause excessive central nervous system depression. Lorazepam's key advantage lies in its pharmacokinetic profile: it undergoes glucuronidation, a conjugation process that occurs outside the liver, primarily in the kidneys. This extrahepatic metabolism ensures that its clearance is less affected by liver dysfunction, reducing the risk of prolonged or excessive sedation. Unlike other benzodiazepines that depend heavily on hepatic cytochrome P450 enzymes, lorazepam's metabolism is more predictable in such patients, making it a safer choice. Excretion in unchanged form or secretion into the GI tract does not apply, and while it is anxiolytic, it does have CNS depressant effects, ruling out other options. Naloxone reverses opioids, not benzodiazepines.

Correct Answer: B

Rationale: Myopathy, characterized by muscle pain or weakness, is a potential side effect associated with the use of HMG-CoA reductase inhibitors, also known as statins. Common examples of statins include atorvastatin, simvastatin, and rosuvastatin. Patients taking statins should be monitored for any signs or symptoms of myopathy, as it can progress to a more serious condition called rhabdomyolysis, where muscle breakdown products can lead to kidney damage. Monitoring for muscle pain, weakness, and elevated creatine kinase levels is essential to detect and manage myopathy promptly in patients on statin therapy.

Correct Answer: C

Rationale: Flumazenil is the specific antidote for Alprazolam, which is a benzodiazepine sedative-hypnotic drug. Flumazenil works by competitively inhibiting the actions of benzodiazepines at the benzodiazepine receptor site on the gamma-aminobutyric acid (GABA) receptor complex. It effectively reverses the sedative effects of benzodiazepines like Alprazolam, making it the appropriate antidote in cases of benzodiazepine overdose or toxicity. The other options provided (Physostigmine, Protamine sulfate, and Acetylcysteine) are unrelated to Alprazolam and are not indicated as antidotes for this specific drug.