An unpleasant sensory and emotional experience associated with actual tissue damage:

Correct Answer: C

Rationale: Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It is a complex phenomenon involving both physical and emotional components. Pain serves as a protective mechanism, alerting the body to potential harm or injury, and prompting appropriate responses to prevent further damage. Pain can be acute or chronic, and may vary in intensity, duration, and location depending on the underlying cause. Analgesia refers to the relief of pain, inflammation is the body's response to injury or infection, and irritation typically refers to a mild reaction to something that is uncomfortable or annoying, but not necessarily indicating tissue damage.

Correct Answer: C

Rationale: Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It is a complex phenomenon involving both physical and emotional components. Pain serves as a protective mechanism, alerting the body to potential harm or injury, and prompting appropriate responses to prevent further damage. Pain can be acute or chronic, and may vary in intensity, duration, and location depending on the underlying cause. Analgesia refers to the relief of pain, inflammation is the body's response to injury or infection, and irritation typically refers to a mild reaction to something that is uncomfortable or annoying, but not necessarily indicating tissue damage.

Correct Answer: B

Rationale: Drugs that block both alpha- and beta-adrenergic receptors are primarily used to treat cardiac-related conditions. Phentolamine, a nonselective alpha-adrenergic blocking agent, is used to treat extravasation of IV norepinephrine or dopamine and hypertension related to a pheochromocytoma. Alpha1-selective adrenergic blocking agents are used for treatment of hypertension and benign prostatic hyperplasia. The beta-adrenergic blocking agents are used to treat cardiovascular problems (hypertension, angina, migraine headaches) and to prevent reinfarction after myocardial infarction. Beta1-selective adrenergic blocking agents are used for treating hypertension, angina, and some cardiac arrhythmias. The nurse should understand the indications for these agents to ensure safe and effective administration.

Correct Answer: B

Rationale: Pharmacodynamics refers to the study of how drugs exert their effects on the body, including the interactions between a drug and its target molecule or receptor leading to a biological response. Understanding a drug's mechanism of action involves determining how it interacts with specific receptors, enzymes, ion channels, or other molecular targets within the body to produce the desired therapeutic effects. Pharmacokinetics, on the other hand, involves the study of how drugs move through the body, including their absorption, distribution, metabolism, and excretion, which although important for determining effective drug dosages and concentrations, does not directly provide insight into how a drug exerts its pharmacological effects. Therapeutic action refers to the overall clinical effect of the drug in treating a specific condition, which is influenced by its pharmacodynamics. Pharmaceutical preparations involve drug formulation and delivery methods, such as tablets, injections, or creams, which affect a drug's bioavailability but do not determine its specific mechanism of action.

Correct Answer: D

Rationale: Tennis is a low-impact activity that is generally safe for patients on methotrexate, as it minimizes the risk of injury and bleeding. High-impact or contact sports like basketball, ice hockey, and football are discouraged due to the increased risk of trauma and bleeding, especially since methotrexate can cause myelosuppression. Encouraging safe physical activity is important for overall health, but precautions must be taken to avoid complications.

Correct Answer: B

Rationale: The first pass effect refers to the metabolism of a drug as it passes through the liver before reaching the systemic circulation. When a drug is absorbed from the gut lumen, it first enters the portal circulation where it is transported to the liver. In the liver, the drug may undergo metabolic processes that can reduce the amount of active drug reaching systemic circulation. This process can greatly affect the overall bioavailability and effectiveness of the drug. So, the metabolism of the drug en route from the gut lumen to the systemic circulation is primarily due to the first pass effect.

Correct Answer: B

Rationale: Naloxone is the antidote commonly used to reverse the effects of opioid toxicity, including hydrocodone. Naloxone works by competitively binding to opioid receptors in the brain, displacing the opioid molecules, and reversing their effects. It effectively antagonizes the respiratory depression, sedation, and analgesic effects caused by opioids like hydrocodone. Administering naloxone can quickly reverse these dangerous effects and help restore respiratory function in cases of opioid overdose or toxicity. Naloxone is commonly used in emergency settings and can be administered intravenously, intramuscularly, or intranasally. It is crucial for healthcare providers to be familiar with naloxone and its administration in managing opioid toxicity.

Correct Answer: D

Rationale: Nesiritide is a recombinant form of human B-type natriuretic peptide (BNP) that is used for the treatment of acutely decompensated heart failure (HF). It is specifically indicated for patients with acute decompensated HF who have dyspnea at rest. Nesiritide works by promoting vasodilation and natriuresis, which helps alleviate symptoms of acute decompensated HF such as dyspnea and edema. Therefore, the patient with acutely decompensated HF who has dyspnea at rest is the best candidate to receive nesiritide therapy to help improve their symptoms and hemodynamic status.

Correct Answer: C

Rationale: Propranolol goes through extensive first-pass hepatic metabolism. This means that after oral administration, a significant portion of the drug is metabolized by the liver before it reaches systemic circulation. This process reduces the bioavailability of propranolol. As a result, higher doses are often required for oral administration compared to other routes of administration, such as intravenous. Heparin, insulin, nitroglycerine, and warfarin do not undergo extensive first-pass metabolism in the liver.