A patient is to receive acetylcysteine (Mucomyst) as part of the treatment for an acetaminophen (Tylenol) overdose. Which action by the nurse is appropriate when giving this medication?

Correct Answer: C

Rationale: Rationale: C is the correct answer because acetylcysteine has a strong, unpleasant taste. Disguising it with soda or flavored water helps improve palatability, increasing the likelihood of the patient taking it. This action enhances adherence to the treatment plan, ensuring the patient receives the full therapeutic benefit. A: Giving the medication undiluted is incorrect as it can lead to nausea and vomiting due to the strong taste. B: Avoiding the use of a straw is incorrect as it doesn't address the issue of the unpleasant taste. D: Acetylcysteine for acetaminophen overdose is typically given orally, not via a nebulizer.

Correct Answer: D

Rationale: The correct answer is D because heparin is a fast-acting anticoagulant that is used initially to rapidly thin the blood while warfarin takes time to reach therapeutic levels. By using both medications together, the patient is protected against blood clots during this transition period. Choices A and B are incorrect because there is no evidence that the oral and injection forms work synergistically or result in fewer adverse effects when used together. Choice C is incorrect because heparin alone can achieve adequate anticoagulation levels, but the combination is more about the timing of onset of action for each medication.

Correct Answer: B

Rationale: The correct answer is B: "Take the bronchodilator inhaler first." The rationale for this instruction is that bronchodilators work by relaxing the muscles around the airways, allowing for easier breathing. Taking the bronchodilator first helps open up the airways, making it easier for the corticosteroid to reach deeper into the lungs and be more effective. If the corticosteroid is taken first, it may not reach the lower airways as effectively. Choice A is incorrect because taking the corticosteroid first may not optimize the effectiveness of both medications. Choice C is incorrect as it is important to take these inhalers in a specific order for optimal effect. Choice D is incorrect because the order of inhaler use can impact the effectiveness of the medications.

Correct Answer: A

Rationale: The correct answer is A because the volume of distribution (Vd) is a pharmacokinetic parameter that describes the extent of drug distribution in the body. It is calculated by dividing the total amount of drug in the body by the concentration of the drug in the plasma. Therefore, the concentration of a substance in plasma is essential for determining Vd. Choice B (Concentration of substance in urine) is incorrect because Vd is not calculated based on urine concentration but rather on plasma concentration. Choice C (Therapeutical width of drug action) is unrelated to Vd calculation as it refers to the range of drug concentrations in the body that produce the desired therapeutic effect. Choice D (A daily dose of drug) is also incorrect as Vd is not directly calculated from the daily dose but rather from the concentration of the drug in the plasma.

Correct Answer: D

Rationale: The correct answer is D: Synergism. When drugs are used in combination, synergism can occur where the combined effect is greater than the sum of their individual effects. This can lead to enhanced therapeutic benefits or increased adverse effects. Tolerance (A) is the body's reduced response to a drug over time. Tachyphylaxis (B) is a rapid decrease in response to a drug with repeated administration. Accumulation (C) refers to the build-up of a drug in the body due to insufficient elimination. Synergism (D) is the only choice that specifically addresses the interaction between drugs leading to enhanced effects.