Allopurinol (Zyloprim) is prescribed for a client for the treatment of gout. And the nurse is providing medication instructions. The nurse tells the client to?

Correct Answer: B

Rationale: Allopurinol should be taken with food to reduce gastrointestinal irritation. Limiting vitamin C intake is advised because it can increase uric acid levels, counteracting the drug's effects. A rash is not a normal side effect and may indicate a hypersensitivity reaction, requiring immediate medical attention. The therapeutic effects of allopurinol are not immediate and may take weeks to become apparent. Proper patient education is essential to ensure adherence and safety.

Correct Answer: D

Rationale: Hirsutism involves excess androgen-driven hair growth. Tamoxifen, an estrogen modulator, treats breast cancer, not hirsutism. Ethinylestradiol reduces androgens via SHBG increase, but alone isn't optimal. Norethisterone, a progestin, may worsen hirsutism. Finasteride blocks 5-alpha-reductase, reducing DHT, but cyproterone, an anti-androgen, directly inhibits androgen receptors and gonadotropin release, the systemic choice for hirsutism (e.g., in PCOS). Its potency targets the root cause, offering effective hair reduction.

Correct Answer: B

Rationale: Beta-lactamase isn't the primary resistance mechanism in pneumococci (PBP alteration is), so that's false. Penicillin's poor penetration into gram-negative bacteria due to outer membranes is a true statement, a common resistance factor. Altered penicillin-binding proteins (PBPs) drive pneumococcal resistance, not the main general mechanism, though true in context. Methicillin resistance in Staph (MRSA) is due to mecA gene producing altered PBPs, not just beta-lactamase, so that's false. Penetration issues in gram-negatives are a fundamental barrier, guiding beta-lactam design like piperacillin.

Correct Answer: B

Rationale: Paroxetine's effectiveness waning after a year suggests possible drug interactions reducing its levels or efficacy, a common issue needing assessment via medication review. Needing a change assumes a conclusion without evidence. Paxil and paroxetine are the same (brand vs. generic), making that question moot. Beck assessment evaluates depression, not drug failure. Interactions align with pharmacokinetic principles, offering a proactive step to identify culprits like enzyme inducers, critical for adjusting therapy.

Correct Answer: A

Rationale: Graded dose-response curves plot individual response intensity to dose increases (e.g., pain relief), a pharmacodynamic tool. Population curves (e.g., ED50) suit groups, not individuals. Large or small groups aggregate data, missing individual nuance. Individual focus defines graded curves, key for tailoring therapy.