A patient is taking procainamide (Pronestyl) for a cardiac dysrhythmia. The nurse will monitor the patient for which possible adverse effect?

Correct Answer: D

Rationale: The correct answer is D: Diarrhea. Procainamide is known to have gastrointestinal side effects, including diarrhea. This adverse effect is important to monitor as it can lead to dehydration and electrolyte imbalances. Bradycardia (A) is not a common side effect of procainamide. Shortened QT interval (B) is not an adverse effect associated with procainamide. Dyspnea (C) is also not a common side effect of procainamide. Monitoring for diarrhea is crucial to prevent complications and ensure patient safety.

Correct Answer: A

Rationale: The correct answer is A: Pretty fast absorption. Sublingual route involves placing the drug under the tongue for direct absorption into the bloodstream through the highly vascular sublingual mucosa. This bypasses the first-pass metabolism in the liver, leading to faster onset of action compared to oral administration. Choice B is incorrect because sublingual administration avoids exposure to gastric secretion. Choice C is incorrect as sublingual administration bypasses liver metabolism. Choice D is incorrect as the variety of doses does not specifically relate to the sublingual route.

Correct Answer: C

Rationale: The correct term for a gradual decrease in responsiveness to a drug over days or weeks is "tolerance." Tolerance occurs due to the body adjusting to the drug's effects, requiring higher doses for the same response. Refractoriness refers to a lack of response, not a reduced response. Cumulative effect refers to increased drug effects with repeated doses. Tachyphylaxis is a rapid decrease in responsiveness, not a gradual one. Therefore, "tolerance" is the best fit for the described scenario.

Correct Answer: B

Rationale: The correct answer is B, Bupivacaine. Bupivacaine is a long-acting local anesthetic with intrinsic vasoconstrictive properties, so using additional vasoconstrictors may not significantly prolong its anesthetic effects. Procaine (A), Lidocaine (C), and Mepivacaine (D) do not have intrinsic vasoconstrictive properties, so adding vasoconstrictors can help prolong their anesthetic effects.

Correct Answer: C

Rationale: The correct answer is C - On effector cell membranes of glandular and smooth muscle cells. The M3 receptor subtype is a muscarinic acetylcholine receptor, which is primarily located on the effector cell membranes of glandular and smooth muscle cells. This receptor subtype plays a key role in mediating parasympathetic responses in these cells. A: In the myocardium - This is incorrect as the M2 receptor subtype is predominantly located in the myocardium, not the M3 subtype. B: In sympathetic postganglionic neurons - This is incorrect as muscarinic receptors are not typically found in sympathetic neurons. D: On the motor end plates - This is incorrect as nicotinic acetylcholine receptors, not muscarinic receptors, are located on motor end plates.