Ester group of local anesthesia differs from the amide group in that :

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Question 1 of 5

Ester group of local anesthesia differs from the amide group in that :

Correct Answer: B

Rationale: The main difference between ester group local anesthetics and amide group local anesthetics lies in the way they are metabolized in the body. Esters are metabolized in the plasma by the enzyme pseudocholinesterase, while amides are metabolized in the liver. Pseudocholinesterase hydrolyzes esters into inactive metabolites, which are then excreted mainly by the kidneys. On the other hand, amides undergo hepatic metabolism by the cytochrome P450 enzyme system before being excreted by the kidneys. This key metabolic difference between esters and amides impacts their pharmacokinetics, including onset of action, duration of effect, and potential for allergic reactions.

Question 2 of 5

A patient who is taking aspirin for arthritis pain asks the nurse why it also causes gastrointestinal upset. The nurse understands that this is because aspirin:

Correct Answer: C

Rationale: Aspirin causes gastrointestinal upset because it inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. These enzymes are responsible for the production of prostaglandins, which are important in protecting the stomach lining. Inhibition of COX-1 reduces the production of protective prostaglandins that help maintain the integrity of the stomach lining, leading to irritation and potential damage, which can manifest as gastrointestinal upset. This is why patients taking aspirin may experience gastrointestinal side effects such as stomach pain, ulcers, or bleeding.

Question 3 of 5

Bisoprolol (Zebeta) would be the drug of choice for which patient with a diagnosis of hypertension?

Correct Answer: D

Rationale: Bisoprolol is the drug of choice for older adults. It is not associated with as many adverse effects in the elderly and regular dosing profiles can be used. This drug does not have an established pediatric dosage. Although the 37-year-old patient is an adult, there are additional choices for this patient, with a more favorable adverse effect profile. The nurse should consider age-related factors when selecting antihypertensive medications.

Question 4 of 5

A patient comes to the office with a chief complaint of hair loss and peeling skin. The nurse notes many vitamins and minerals are on the medication list. The patient reports using vitamins to treat liver disease. The patient's complaint may be caused by an excess of which vitamin or mineral?

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 5 of 5

When caring for an elderly Chinese patient, the nurse recognizes that which of these cultural issues may influence the care of this patient?

Correct Answer: C

Rationale: In Chinese culture, the use of heat, such as through warm foods or heating pads, is often believed to restore balance and promote healing. This cultural practice may influence the patient's preferences and expectations during hospitalization. Radiographs, hospital diets, and the perception of hospitalization are less likely to be significant cultural factors in this context. Therefore, the nurse should consider the patient's cultural beliefs about heat and incorporate them into the care plan as appropriate.

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