A patient suffering from generalized anxiety disorder (GAD) has a history of drug dependence that includes the illicit use of secobarbital ('reds') and a variety of other drugs. Psychotherapy is indicated, but the physician also prescribes a drug that can be helpful in GAD and that has the advantage of no abuse liability. The drug prescribed was most likely to have been

Correct Answer: B

Rationale: Buspirone, a 5HT1A partial agonist, treats GAD by modulating serotonin without sedative or euphoric effects, making it ideal for patients with substance abuse histories like secobarbital (a barbiturate). It lacks abuse potential, unlike benzodiazepines, and doesn't cause dependence, aligning with the patient's needs. Bupropion, an NE/DA reuptake inhibitor, targets depression and smoking cessation, not GAD, and has stimulant-like risks. Baclofen, a GABA_B agonist, manages spasticity, not anxiety, and has some abuse potential. Buprenorphine, an opioid partial agonist, treats addiction but not GAD and carries dependence risk. Phenobarbital, a barbiturate, mirrors the patient's abuse history and is contraindicated. Buspirone's efficacy in GAD, non-addictive nature, and safety in this context make it the optimal choice.

Correct Answer: D

Rationale: Nystatin treats infant thrush, often linked to maternal Candida transmission during breastfeeding. The key instruction 'The breastfeeding mother may also require treatment' prevents reinfection (correct answers: 3, 5), addressing the cycle comprehensively. Before feeding reduces efficacy as milk washes it away. Water dilutes the dose unnecessarily. Cotton swab application ensures coverage but isn't the priority over maternal treatment. Choice D ensures long-term success, critical for caregiver education and infection control.

Correct Answer: C

Rationale: Levothyroxine replaces thyroid hormone, requiring optimal absorption for efficacy. Taking it on an empty stomach in the morning avoids interference from food (e.g., calcium, iron), which reduces uptake, ensuring consistent T4 levels. With breakfast or dinner , absorption drops due to dietary interactions, risking subtherapeutic effects. At bedtime is viable but less ideal if food was recent, and morning aligns with circadian thyroid function. This timing leverages levothyroxine's pharmacokinetics'long half-life but sensitivity to gut contents'maximizing bioavailability. Instructing this prevents treatment failure in hypothyroidism, where precise dosing matters, making C the best time for administration and client education.

Correct Answer: D

Rationale: Amitriptyline, a tricyclic antidepressant, has anticholinergic effects that slow gastric motility, reducing the rate of gastric emptying.