All are true about penicillins EXCEPT:

Correct Answer: B

Rationale: Penicillins cross the blood-brain barrier mainly when meninges are inflamed (e.g., meningitis), a true statement due to increased permeability. They do require dose adjustment in renal failure, as they're renally excreted, making the lack of adjustment false and the exception. They inhibit bacterial cell wall synthesis by blocking peptidoglycan cross-linkage, a true mechanism. Piperacillin is effective against Pseudomonas, especially with tazobactam, which is true. Only 5-10% of those with prior penicillin allergy react again, also true. The renal adjustment need is critical, as accumulation risks toxicity like seizures, guiding safe prescribing in kidney dysfunction.

Correct Answer: C

Rationale: A P450 enzyme inducer (e.g., rifampin) speeds metabolism of itself and other drugs, reducing its own effect over time as levels drop faster, requiring dose adjustments. No effect on others is extreme-some drugs' metabolism increases, lowering their effect. Increased effects suggest inhibition, not induction. Self-induction lowers efficacy, a pharmacokinetic principle affecting long-term use.

Correct Answer: B

Rationale: Aging reduces liver/renal clearance, raising plasma levels (e.g., digoxin), heightening response and toxicity risk, per pharmacokinetics. Body water drops, concentrating drugs, not diluting. Doses decrease, not increase-metabolism slows. Absorption may slow, but pH rises, not falls. Plasma increase drives effects, key in elders.

Correct Answer: B

Rationale: The best instruction by the nurse for a client taking calcium supplements is option B: "Take your calcium with a meal." This is the correct answer because calcium is best absorbed when taken with food. Food helps the body better absorb and utilize the calcium supplement, leading to improved effectiveness. Option A, "This drug may cause insomnia," is incorrect because insomnia is not a common side effect of calcium supplements. Providing this information may cause unnecessary concern or confusion for the client. Option C, "It does not matter if vitamin D is added," is incorrect because vitamin D is essential for the absorption of calcium. Instructing the client that it does not matter if vitamin D is added could lead to inadequate absorption of calcium, resulting in potential health issues. Option D, "Take them on an empty stomach," is also incorrect. Taking calcium supplements on an empty stomach can reduce their absorption and effectiveness. Instructing the client to take them on an empty stomach would be counterproductive to achieving the desired health benefits. In an educational context, it is crucial for nurses to provide accurate and clear instructions regarding medication administration to ensure optimal therapeutic outcomes for their patients. Understanding the proper timing and conditions for taking medications, such as calcium supplements, is essential in promoting patient safety and adherence to the prescribed regimen. By explaining the rationale behind the correct answer and addressing why the other options are incorrect, nurses can empower their patients to make informed decisions about their health.

Correct Answer: D

Rationale: Procainamide can induce a lupus-like syndrome . Symptoms (malaise, fever, nausea) and malar rash mimic SLE, a known side effect due to drug-induced autoantibodies. Contact dermatitis lacks systemic features. Sun reaction or discoid lupus don't fit the drug link. Collagen disease (E) is vague. This reversible syndrome resolves with discontinuation, distinguishing it from primary lupus.