A patient was prescribed sertraline (Zoloft) for the treatment of depression and anxiety. The patient's spouse calls the clinic and reports the patient is increasingly moody and seems 'disconnected with life.' What is the best response by the nurse?

Correct Answer: B

Rationale: The correct response is option B: "Bring him to the clinic for assessment today." This option is the best choice because the patient's change in mood and feeling disconnected could be indicative of a serious reaction to the sertraline medication. It is crucial to assess the patient in person to evaluate their mental and emotional state, as well as any potential side effects or complications from the medication. Option A is incorrect because diphenhydramine is not a recommended treatment for mood changes associated with sertraline. It is essential to address the underlying issue rather than attempting to mask symptoms with another medication. Option C is incorrect because abruptly stopping sertraline can lead to withdrawal symptoms and may not address the root cause of the patient's mood changes. It is important to consult with a healthcare provider before making any changes to the medication regimen. Option D is incorrect because doubling the dose of sertraline without proper evaluation can be dangerous and may exacerbate the patient's symptoms. Adjusting medication dosages should only be done under the guidance of a healthcare professional. In an educational context, this question highlights the importance of vigilant monitoring of patients on psychotropic medications for mental health conditions. It emphasizes the need for healthcare providers to respond promptly to reports of concerning symptoms and to prioritize patient safety and well-being in medication management. Regular assessment and communication with patients and their families are vital aspects of providing quality care in pharmacology and mental health practice.

Correct Answer: C

Rationale: The correct answer is C) Histidine. Histamine is derived from histidine through the decarboxylation process. Histidine is an essential amino acid that serves as a precursor for histamine synthesis in the body. When histidine undergoes decarboxylation, it forms histamine, which plays a crucial role in the immune response and allergic reactions. Option A) L-arginine is not the correct choice as it is not the precursor for histamine synthesis. L-arginine is involved in the synthesis of nitric oxide and urea in the body. Option B) Heparin is a naturally occurring anticoagulant and is not involved in histamine synthesis. Heparin is synthesized in mast cells and acts as a blood thinner. Option D) Lysine is an essential amino acid but is not the precursor for histamine synthesis. Lysine plays a role in protein synthesis and is not directly involved in histamine production. Understanding the biochemical pathways involved in histamine synthesis is crucial for pharmacology students as it helps in comprehending how antihistamines work and their mechanisms of action in treating allergic reactions. Knowing the relationship between histidine and histamine can aid in better understanding the treatment of allergic conditions and the rationale behind using antihistamines.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) β-Blockers. When a patient presents with myocardial infarction after cocaine use, β-Blockers are contraindicated due to their potential to worsen coronary vasoconstriction caused by cocaine. Cocaine use can lead to unopposed α-adrenergic stimulation, and β-Blockers can exacerbate this effect, leading to severe hypertension, coronary artery vasospasm, and potential worsening of the myocardial infarction. A) ACE inhibitors and B) Aspirin are commonly used in the treatment of myocardial infarction and are not contraindicated in this case. ACE inhibitors help reduce the workload on the heart and prevent further damage, while aspirin is essential in preventing platelet aggregation and thrombus formation. D) Calcium channel blockers are also contraindicated in this scenario as they can worsen coronary vasoconstriction and cardiovascular effects induced by cocaine. Educationally, this case highlights the importance of considering the unique contraindications and interactions of medications in specific clinical situations. Understanding the pharmacological effects of drugs in different contexts is crucial for providing safe and effective patient care, especially in emergency situations like myocardial infarction precipitated by cocaine use.

Correct Answer: D

Rationale: Riluzole is the only FDA-approved drug for ALS, extending survival by inhibiting glutamate release, reducing excitotoxicity that accelerates motor neuron death. It modestly slows progression, offering a disease-modifying effect. Pramipexole and selegiline, dopamine-related drugs, treat Parkinson's, not ALS. Galantamine, a cholinesterase inhibitor, targets Alzheimer's cognition. Glatiramer manages MS via immune modulation. Riluzole's glutamate antagonism addresses ALS's neurodegenerative mechanism, backed by clinical trials, making it uniquely approved for this fatal condition.

Correct Answer: A

Rationale: HRT, often involving estrogen, increases thrombophlebitis risk due to enhanced clotting factors. Calf pain signals possible deep vein thrombosis (DVT), a life-threatening side effect requiring immediate assessment, as it could lead to pulmonary embolism. Decreased libido , low-back pain , and fatigue may occur with HRT but are less urgent and not specific to its most dangerous complications. The nurse prioritizes calf pain due to its association with thromboembolism, a well-documented HRT risk, especially in smokers or those with vascular issues, making choice A the critical focus for safety.