A pregnant patient who is at 32 weeks' gestation has a cold and calls the office to ask about taking an over-the-counter medication that is rated as pregnancy category A. Which answer by the nurse is correct?

Correct Answer: D

Rationale: Pregnancy category A indicates that adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus. Therefore, the nurse can reassure the patient that the medication is safe to take as directed. The other options either overstate the risk or provide incomplete information. It is important for the nurse to provide accurate and evidence-based guidance to ensure the safety of both the patient and the fetus.

Correct Answer: D

Rationale: Serotonin reuptake blockade increases synaptic levels. Buspirone, a 5-HT1A agonist, treats anxiety without reuptake effects. Pizotifen, a serotonin antagonist, prevents migraines. Granisetron, a 5-HT3 antagonist, controls nausea. Paroxetine, an SSRI, potently inhibits serotonin reuptake, elevating mood in depression. Sumatriptan activates 5-HT1 receptors. Paroxetine's mechanism is central to its antidepressant efficacy, distinguishing it from receptor modulators.

Correct Answer: B

Rationale: Ethanol competes with methanol metabolism, not enhances it, increasing toxicity, so that's false. Grapefruit juice inhibits CYP3A4, reducing cyclosporin metabolism, raising levels, a true statement critical for transplant patients. Phenytoin induces, not inhibits, theophylline metabolism, lowering levels. Rifampicin induces, not inhibits, oral contraceptive metabolism, reducing efficacy. Griseofulvin induces warfarin metabolism, not inhibits. Grapefruit juice's effect is a classic drug-food interaction, necessitating dose adjustments or avoidance.

Correct Answer: A

Rationale: When a client receives total parenteral nutrition (TPN), monitoring blood glucose levels is critical due to the high glucose content in TPN solutions, which can lead to hyperglycemia. This condition arises because TPN delivers concentrated nutrients directly into the bloodstream, bypassing the digestive system, and the body may struggle to regulate sugar levels effectively without proper insulin response. Potassium levels, while important in overall electrolyte balance, are less immediately impacted by TPN compared to glucose, as potassium imbalances typically develop over time rather than acutely from TPN initiation. Mental status assessments are valuable for neurological conditions but lack direct relevance to TPN's metabolic effects. Similarly, blood pressure monitoring is essential for cardiovascular health but isn't the primary concern with TPN, as it doesn't directly influence hypertension or hypotension in the same way glucose dysregulation does. The focus on glucose stems from its rapid impact on the client's metabolic state, making it the priority assessment to prevent complications like hyperglycemia, which can escalate to severe outcomes if unaddressed. Regular monitoring ensures timely intervention, aligning with TPN's nutritional goals.

Correct Answer: C

Rationale: The liver, via portal vein metabolism, drives the first-pass effect, reducing oral drug bioavailability (e.g., morphine) before systemic circulation. Bladder and kidneys excrete, not metabolize first. Stomach degrades some, but liver's enzyme activity dominates. First-pass is liver-centric, shaping dosing.