After a severe auto accident, a patient has been taken to the trauma unit and has an estimated

Correct Answer: D

Rationale: Packed red blood cells (PRBCs) are the most appropriate product to administer after a severe auto accident when there is significant blood loss and anemia. PRBCs are used to increase the oxygen-carrying capacity of the blood and improve tissue oxygenation. They are specifically designed to deliver red blood cells without the unnecessary components found in whole blood. This targeted approach helps to avoid volume overload and reduce the risk of complications such as transfusion reactions. In a trauma situation where there is active bleeding and a need to rapidly restore oxygen-carrying capacity, PRBCs are the preferred blood product.

Correct Answer: B

Rationale: The first pass effect refers to the metabolism of a drug occurring as it passes from the gastrointestinal tract (GUT lumen) to the liver, before reaching the systemic circulation. This process can significantly reduce the amount of active drug that enters systemic circulation, impacting the drug's overall effectiveness. The first pass effect is an important consideration in pharmacokinetics as it affects the bioavailability of a drug and influences dosing regimens. Options A, C, D, and E do not specifically pertain to the metabolism of a drug en route from the GUT lumen to the systemic circulation as described in the question.

Correct Answer: A

Rationale: UTI in pregnancy needs safe, effective antibiotics. Amoxicillin, a penicillin, is safe (category B), effective against common pathogens (e.g., E. coli), and suitable in early pregnancy. Trimethoprim risks folate antagonism, avoided in first trimester. Tetracycline causes fetal bone/teeth damage, contraindicated. Erythromycin and flucloxacillin are less targeted for UTI. Amoxicillin's safety and efficacy make it ideal, protecting mother and fetus.

Correct Answer: C

Rationale: Prednisone, a corticosteroid, manages inflammation but risks serious side effects. Blurred vision may signal glaucoma or cataracts, ocular emergencies requiring immediate reporting to prevent vision loss. Increased appetite and weight gain are common, manageable effects of cortisol excess. Mood swings occur due to CNS effects but are less urgent unless severe. Blurred vision stands out as a rare but critical adverse reaction, linked to prednisone's long-term impact on intraocular pressure or lens opacity. Teaching this ensures early detection, aligning with corticosteroid monitoring where eye complications can escalate fast. Appetite, weight, and mood changes, while disruptive, don't match this urgency, making C the priority side effect for the client to report promptly.

Correct Answer: D

Rationale: Digoxin belongs to the class of drugs known as cardiac glycosides. Cardiac glycosides are a group of compounds derived from plants and some animals that have the ability to increase the contractility of the heart muscle. Digoxin is commonly used to treat conditions such as congestive heart failure and irregular heart rhythms. It works by inhibiting the sodium-potassium pump in heart muscle cells, leading to an increase in intracellular calcium levels and subsequently improving the heart's pumping ability.

Correct Answer: D

Rationale: Packed red blood cells (PRBCs) are the most appropriate product to administer after a severe auto accident when there is significant blood loss and anemia. PRBCs are used to increase the oxygen-carrying capacity of the blood and improve tissue oxygenation. They are specifically designed to deliver red blood cells without the unnecessary components found in whole blood. This targeted approach helps to avoid volume overload and reduce the risk of complications such as transfusion reactions. In a trauma situation where there is active bleeding and a need to rapidly restore oxygen-carrying capacity, PRBCs are the preferred blood product.

Correct Answer: C

Rationale: Transdermal nitroglycerin patches are most appropriately used to prevent the occurrence of angina. Nitroglycerin is a vasodilator that works by relaxing and widening blood vessels, which helps to increase blood flow and oxygen to the heart muscle. By using nitroglycerin patches regularly, the patient can help prevent episodes of angina, which is chest pain or discomfort that occurs when the heart muscle does not receive enough oxygen-rich blood. Nitroglycerin patches are not used to prevent low blood pressure, relieve shortness of breath, or control heart rate during exercise.

Correct Answer: C

Rationale: Codeine, an opioid antitussive, can cause respiratory depression as a side effect. The nurse must assess the patient’s respiratory rate before administration to ensure it is within a safe range (typically >12 breaths per minute). While lung sounds (B) and sputum consistency (D) are important, they are not the priority when administering a medication that can suppress respiration. Pulse oximetry (A) is useful but secondary to direct respiratory rate assessment.

Correct Answer: D

Rationale: Recurrent allergic symptoms post-bee sting suggest ongoing inflammation. Prednisolone , a corticosteroid, reduces late-phase reactions. Diphenhydramine and Loratadine treat acute symptoms. Epinephrine is for anaphylaxis but short-acting. Prednisolone prevents biphasic reactions, avoiding his return.