A patient with chronic depression is prescribed bupropion. Bupropion works primarily by:

Correct Answer: B

Rationale: Bupropion inhibits the reuptake of norepinephrine and dopamine. This leads to increased levels of these neurotransmitters in the brain, which can help alleviate symptoms of depression. This mechanism of action is well-documented in pharmacology and supported by clinical studies. Other choices are incorrect because bupropion does not primarily affect serotonin reuptake, block serotonin receptors, or increase the release of acetylcholine in the brain.

Correct Answer: B

Rationale: Step-by-step rationale: 1. Ipratropium bromide is a bronchodilator commonly used in COPD. 2. It works by relaxing muscles in the airways to improve breathing. 3. Asthma is typically treated with other bronchodilators like albuterol. 4. Hypertension is managed with antihypertensive medications. 5. Arrhythmia is treated with antiarrhythmic drugs. In summary, ipratropium bromide is specifically indicated for COPD due to its mechanism of action on the airways, making choices A, C, and D incorrect for this question.

Correct Answer: A

Rationale: The correct answer is A because alendronate is a bisphosphonate that inhibits bone resorption by osteoclasts. Osteoclasts are responsible for breaking down bone tissue, and alendronate helps to reduce bone loss by suppressing their activity. This leads to an increase in bone mineral density and strength. Choices B, C, and D are incorrect because alendronate does not promote bone formation by osteoblasts, increase calcium absorption in the intestines, or inhibit the synthesis of collagen. The primary mechanism of action of alendronate is through the inhibition of osteoclast-mediated bone resorption.

Correct Answer: B

Rationale: The correct answer is B: Prothrombin time (PT) and international normalized ratio (INR). PT measures the time it takes for blood to clot, and INR is a standardized way to interpret PT results. Warfarin affects the clotting process, so monitoring PT/INR helps assess its therapeutic effect. CBC (A) checks blood cell counts, not specific to warfarin. Serum creatinine (C) assesses kidney function, not related to warfarin. Liver function tests (D) evaluate liver health, not directly related to warfarin's anticoagulant effect. PT/INR is the key test for monitoring warfarin therapy.

Correct Answer: B

Rationale: The correct answer is B: Metformin. Metformin is recommended as the first-line treatment for type 2 diabetes because it effectively lowers blood sugar levels, has a good safety profile, and can reduce the risk of cardiovascular events. It works by decreasing glucose production in the liver and improving insulin sensitivity. Insulin (A) is typically used when other medications are not effective enough. Glipizide (C) and Pioglitazone (D) are alternative options but have more side effects and risks compared to metformin.