An unresponsive patient who was brought to the emergency department has been reportedly taking alprazolam for a severe anxiety disorder after the mother's death. Knowing this history, which drug would the nurse anticipate administering?

Correct Answer: D

Rationale: The correct answer is D: Flumazenil. Flumazenil is a benzodiazepine receptor antagonist used to reverse the effects of benzodiazepine overdose, such as alprazolam. In this case, the patient's unresponsiveness is likely due to alprazolam overdose, so administering flumazenil would help reverse its effects. A: Mannitol is a diuretic used to reduce intracranial pressure in conditions like cerebral edema. B: Naloxone is an opioid receptor antagonist used to reverse opioid overdose. C: Activated charcoal is used to absorb ingested toxins in cases of poisoning, not for benzodiazepine overdose.

Correct Answer: A

Rationale: The correct answer is A: immunoglobulin E (IgE). IgE is responsible for mediating Type I immediate hypersensitivity reactions, such as allergic reactions. IgE binds to allergens and triggers the release of histamine and other inflammatory mediators from mast cells, leading to symptoms like hives and anaphylaxis. IgG (B), IgA (C), and IgM (D) are not typically involved in Type I allergic reactions. IgG is involved in Type II and Type III hypersensitivity reactions, IgA is related to mucosal immunity, and IgM is mainly involved in the primary immune response.

Correct Answer: B

Rationale: The correct answer is B: Pituitary somatotrophs. Octreotide is a somatostatin analog that inhibits the release of growth hormone. Somatotrophs in the pituitary gland are the cells responsible for producing and releasing growth hormone. By acting on these cells, octreotide can effectively reduce the elevated levels of growth hormone seen in acromegaly. Supraoptic neurons (A) are responsible for producing and releasing vasopressin, not growth hormone. Pituitary thyrotrophs (C) produce and release thyroid-stimulating hormone, not growth hormone. Paraventricular neurons (D) are involved in regulating oxytocin release, not growth hormone. Therefore, the main site of action of octreotide in acromegaly is on pituitary somatotrophs.

Correct Answer: D

Rationale: The correct answer is D: Cabergoline. Cabergoline is a dopamine agonist used to treat hyperprolactinemia. It is appropriate to add to therapy if the patient has hyperprolactinemia symptoms. Cosyntropin (A) is a synthetic ACTH used to test adrenal gland function. Mecasermin (B) is a recombinant IGF-1 used to treat growth hormone insensitivity. Leuprolide (C) is a GnRH agonist used to treat conditions like endometriosis and prostate cancer. None of these options are appropriate for hyperprolactinemia, making D the correct choice.

Correct Answer: A

Rationale: Step-by-step rationale for the correct answer (A: Pegvisomant): 1. Patient likely has acromegaly due to elevated growth hormone levels. 2. Pegvisomant is a growth hormone receptor antagonist used to treat acromegaly by blocking the effects of growth hormone. 3. This drug would be appropriate to normalize the patient's growth hormone levels and improve symptoms. Summary of why other choices are incorrect: - B: Degarelix is a gonadotropin-releasing hormone antagonist used in prostate cancer, not for acromegaly. - C: Leuprolide is a gonadotropin-releasing hormone agonist used in various conditions like prostate cancer and endometriosis, not for acromegaly. - D: Cosyntropin is a synthetic form of adrenocorticotropic hormone used in diagnostic testing for adrenal function, not for acromegaly treatment.