A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse will include which information?

Correct Answer: A

Rationale: Option E is the correct answer. When a patient with type II diabetes is taking a beta blocker, it's important to monitor blood glucose levels regularly for possible changes in glucose levels. Beta blockers can mask the symptoms of hypoglycemia, such as tremors and rapid heartbeat, which can make it harder for patients to recognize when their blood sugar is too low. On the other hand, beta blockers can also potentially lead to hyperglycemia as they can blunt the body's response to hypoglycemia by inhibiting the release of counter-regulatory hormones like epinephrine. Therefore, monitoring blood glucose levels is crucial in such patients to prevent complications related to blood sugar fluctuations.

Correct Answer: B

Rationale: Haloperidol treats schizophrenia's positive symptoms, but compliance is the priority outcome, as relapse follows non-adherence. Fluids/fiber manage side effects. Hallucination reduction depends on compliance. Restlessness signals issues, not a goal. B ensures treatment success, making it the priority.

Correct Answer: A

Rationale: Enteral drug administration is the route where the drug is placed directly into the gastrointestinal tract (GIT), such as through the mouth (oral administration) or through a feeding tube. Once administered, the drug is absorbed through the walls of the GI tract into the bloodstream for systemic distribution. This is in contrast to parenteral routes where drugs are administered by methods other than through the digestive system, such as injections, inhalation, or topical application. Intravenous (IV) administration, specifically mentioned in the question, is a type of parenteral route where drugs are injected directly into a vein for rapid and complete systemic distribution.

Correct Answer: D

Rationale: A phenytoin level of 25 mcg/ml is above the therapeutic range (10-20 mcg/ml) and can cause toxicity symptoms such as nystagmus, ataxia, and confusion. Hyperactivity and tremors are not typical signs of phenytoin toxicity. Therefore, nystagmus is the expected symptom.

Correct Answer: B

Rationale: SSRIs (e.g., fluoxetine) can cause rash as a hypersensitivity reaction, true. Weight gain isn't a hallmark side effect (unlike TCAs); some cause weight loss or neutrality, making this the exception, though key says B is true (possible typo). Sexual dysfunction (e.g., delayed ejaculation) is common, true. Anxiety can occur initially, true. GI symptoms like nausea are frequent. Per the key, weight gain isn't typical, distinguishing SSRIs from other antidepressants in side effect profiles.

Correct Answer: A

Rationale: Vancomycin, used for resistant infections, can cause red man syndrome 'flushing, rash, and pruritus on the upper body'due to histamine release from rapid IV infusion. Monitoring for this allows slowing the rate (e.g., over 1-2 hours), preventing discomfort or anaphylactoid reactions. Hypotension may occur secondary to this but isn't primary. Fever and nausea are less specific to infusion speed. Red man syndrome's distinct presentation ties directly to vancomycin's administration, a well-known risk mitigated by nursing vigilance. This focus ensures safe delivery, distinguishing it from systemic effects, making A the key reaction to watch during infusion.

Correct Answer: C

Rationale: ACE inhibitors decrease the renin angiotensin aldosterone system by blocking the angiotensin-converting enzyme (ACE), which converts angiotensin I to angiotensin II. By inhibiting this enzyme, ACE inhibitors reduce the production of angiotensin II, a potent vasoconstrictor, and lower aldosterone secretion. This leads to vasodilation, decreased blood pressure, and reduced retention of sodium and water. Consequently, ACE inhibitors are commonly used in the management of hypertension, heart failure, and chronic kidney disease.

Correct Answer: B

Rationale: Acute falciparum malaria from Nigeria, a chloroquine-resistant area, requires effective therapy. Chloroquine is ineffective due to resistance. Proguanil/atovaquone (Malarone) treats uncomplicated falciparum malaria, rapid-acting and well-tolerated, most appropriate here. Primaquine targets liver stages, not acute blood infection. Pyrimethamine and hydroxychloroquine are less effective. Malarone's efficacy ensures rapid parasite clearance, vital in this potentially severe disease.

Correct Answer: A

Rationale: Option E is the correct answer. When a patient with type II diabetes is taking a beta blocker, it's important to monitor blood glucose levels regularly for possible changes in glucose levels. Beta blockers can mask the symptoms of hypoglycemia, such as tremors and rapid heartbeat, which can make it harder for patients to recognize when their blood sugar is too low. On the other hand, beta blockers can also potentially lead to hyperglycemia as they can blunt the body's response to hypoglycemia by inhibiting the release of counter-regulatory hormones like epinephrine. Therefore, monitoring blood glucose levels is crucial in such patients to prevent complications related to blood sugar fluctuations.