Metformin most likely causes which of the following?

Correct Answer: B

Rationale: The correct answer is B: Increased insulin sensitivity. Metformin works by decreasing hepatic glucose production, increasing peripheral glucose uptake, and improving insulin sensitivity in tissues. It does not increase gluconeogenesis (A), decrease GI glucose absorption (C), or increase pancreatic insulin release (D). By enhancing insulin sensitivity, Metformin helps lower blood glucose levels in individuals with type 2 diabetes.

Correct Answer: B

Rationale: The correct answer is B: Amitriptyline. This tricyclic antidepressant is commonly used to manage neuropathic pain, improve sleep quality, and treat depression. Amitriptyline can help alleviate the patient's symptoms of poor sleep, depressed mood, poor appetite, and neuropathic pain due to its dual mechanism of action that involves inhibiting the reuptake of serotonin and norepinephrine. A: Lorazepam is a benzodiazepine used for anxiety and insomnia, but it does not address neuropathic pain or depression symptoms. C: Trazodone is a sedating antidepressant often used for insomnia, but it may not be as effective for neuropathic pain as amitriptyline. D: Escitalopram is a selective serotonin reuptake inhibitor (SSRI) used for depression and anxiety, but it may not be as effective for neuropathic pain as amitriptyline.

Correct Answer: A

Rationale: The correct answer is A: History of liver disease. The liver plays a crucial role in drug metabolism. Any dysfunction or damage to the liver, such as in liver disease, can significantly affect the metabolism of drugs, leading to altered drug levels in the body. This can result in potential toxicity or reduced efficacy of medications. In contrast, choices B, C, and D do not have a direct impact on drug metabolism like liver disease does. A vegetarian diet, sedentary lifestyle, or being a teacher do not specifically influence the liver's ability to metabolize drugs. Thus, history of liver disease is the most critical assessment data to consider in understanding drug metabolism.

Correct Answer: A

Rationale: The correct answer is A: Notify physician of allergic reaction. This is the priority action because hives can be a sign of an allergic reaction to a new medication, which can progress to a severe systemic reaction like anaphylaxis. Immediate physician notification is essential for prompt management, such as discontinuation of the medication and initiation of appropriate treatment. B: Idiosyncratic reactions are unpredictable and not related to allergies, so it is not the priority in this case. C: Teratogenicity refers to the potential harm to a fetus, which is not relevant when assessing hives in a patient. D: Tolerance is the body's decreased response to a medication over time, not a concern with hives in a patient on a new medication.

Correct Answer: C

Rationale: The correct answer is C: Fluconazole. This is because fluconazole is a systemic antifungal medication commonly used to treat systemic fungal infections. It has a broad spectrum of activity and is well-absorbed orally, making it suitable for systemic therapy. Amphotericin B (choice A) is used for severe systemic fungal infections due to its high toxicity. Nystatin (choice B) is primarily used topically for mucocutaneous candidiasis. Flucytosine (choice D) is used in combination therapy for systemic fungal infections, but fluconazole is typically preferred for initial therapy due to its lower toxicity profile and ease of administration.