A patient has been taking phenobarbital for 2 weeks as part of his therapy for epilepsy. He tells the nurse that he feels tense and that 'the least little thing' bothers him now. Which is the correct explanation for this problem?

Correct Answer: D

Rationale: The correct answer is D because phenobarbital, a barbiturate, suppresses REM sleep, leading to a decrease in the body's ability to cope with stress. This can result in increased tension and irritability. Choice A is incorrect as the adverse effects mentioned are not expected to subside after a few weeks with this drug. Choice B is incorrect because stopping the drug abruptly can lead to withdrawal symptoms and potential seizures in epilepsy patients. Choice C is incorrect as it misrepresents the effect of phenobarbital on REM sleep, as it decreases REM sleep instead of increasing it.

Correct Answer: D

Rationale: The correct answer is D: Liver dysfunction. Antilipemic therapy can impact liver function due to the role of the liver in metabolizing lipids. Monitoring for liver dysfunction is crucial to prevent potential complications. Neutropenia (A) is unrelated to antilipemic therapy. Pulmonary problems (B) are not typically associated with this therapy. Vitamin C deficiency (C) is not a common concern in antilipemic treatment. In summary, monitoring for liver dysfunction is essential due to the potential impact of antilipemic therapy on liver function.

Correct Answer: C

Rationale: The correct answer is C: Black, tarry stools. Iron supplements commonly cause gastrointestinal side effects, including constipation and dark-colored stools. The black, tarry stools indicate the presence of iron in the stool. Palpitations (A) are not a common side effect of oral iron supplements. Drowsiness and dizziness (B) are not typically associated with iron supplementation. Orange-red discoloration of the urine (D) is a side effect of medications like phenazopyridine, not iron supplements. It is important to monitor for black, tarry stools as it may indicate gastrointestinal bleeding.

Correct Answer: A

Rationale: The correct answer is A. Drugs with high glomerular filtration rate are quickly filtered into the renal tubules, and those actively secreted enhance elimination. Furthermore, not being passively reabsorbed prevents reabsorption into the bloodstream, leading to rapid elimination. Choice B is incorrect because it contradicts the concept of rapid drug elimination based on renal processes. Choice C is incorrect as it does not provide any information. Choice D is incorrect because not all drugs have high glomerular filtration rate, active secretion, and lack of passive reabsorption, which are key factors for rapid elimination.

Correct Answer: C

Rationale: 1. Procaine is an ester-type local anesthetic derived from paraaminobenzoic acid. 2. Esters of paraaminobenzoic acid have the suffix "-caine" in their generic names. 3. Mepivacaine, lidocaine, and cocaine are all amide-type local anesthetics. 4. Cocaine is derived from the coca plant and not from paraaminobenzoic acid.