Parenteral penicillin can be administered as an:

Correct Answer: A

Rationale: Parenteral administration refers to delivering medications via routes other than the digestive tract, typically involving injections. Penicillin, a widely used antibiotic, can be administered through specific parenteral routes to ensure optimal absorption, efficacy, and safety. The correct answer is **A (IM injection or an IV solution)** because penicillin formulations are specifically designed for intramuscular (IM) or intravenous (IV) administration. IM injections allow for slower absorption into the bloodstream, suitable for drugs like penicillin G benzathine, which provides prolonged action. IV administration delivers the drug directly into the bloodstream, ensuring rapid onset, which is critical in severe infections. Both methods are well-supported by pharmacokinetic studies and clinical practice guidelines. **Why other options are incorrect:** - **B (IV or intradermal injection):** Intradermal injections are used primarily for diagnostic tests (e.g., tuberculin skin tests) or vaccines, not for antibiotics like penicillin. The intradermal route lacks the capacity to deliver the volume or achieve the systemic drug levels required for antibiotic efficacy. - **C (Intradermal or subcutaneous injection):** Subcutaneous injections are unsuitable for penicillin because they can cause significant local irritation and inadequate absorption. Penicillin’s molecular properties and irritation potential make this route impractical, unlike drugs like insulin or heparin, which are designed for subcutaneous delivery. - **D (IM or subcutaneous injection):** While IM is correct, subcutaneous administration is inappropriate for penicillin due to the risk of tissue damage and inconsistent absorption. The subcutaneous layer lacks the vascularity needed for efficient drug distribution, leading to subtherapeutic levels and potential adverse reactions. The distinction between these routes hinges on the drug’s physicochemical properties, therapeutic goals, and anatomical considerations. Penicillin’s stability, solubility, and irritation profile limit its administration to IM or IV routes, ensuring both safety and clinical effectiveness. Misapplication via incorrect routes (e.g., intradermal or subcutaneous) could compromise treatment outcomes or cause harm, underscoring the importance of adhering to evidence-based administration practices.

Correct Answer: C

Rationale: To determine the flow rate in drops per minute, multiply the ordered volume per hour by the drop factor (100 ml/hour x 15 gtt/ml = 1500 gtt/hour). Then, divide the result by 60 minutes to convert it to drops per minute (1500 gtt/hour · 60 minutes = 25 gtt/minute). Therefore, the correct answer is 25 gtt/minute.

Correct Answer: A

Rationale: Hemoglobinuria is a characteristic sign of a hemolytic reaction to a blood transfusion. Hemolytic reactions can lead to the destruction of red blood cells, causing the release of hemoglobin into the urine, which presents as hemoglobinuria. Chest pain, urticaria, and distended neck veins are not specific signs of a hemolytic reaction and may be associated with other conditions or reactions.

Correct Answer: C

Rationale: Renal failure often necessitates fluid restriction to prevent fluid overload. In renal failure, the kidneys are unable to effectively filter and excrete excess fluids, leading to fluid accumulation in the body. Restricting fluid intake helps manage this condition by preventing further fluid buildup and complications such as edema and electrolyte imbalances.

Correct Answer: C

Rationale: Orthopnea is a condition where a person experiences difficulty breathing when lying flat but finds relief when sitting up or standing. Elevating the head of the bed to the high Fowler position helps alleviate this symptom. Tachypnea refers to rapid breathing, eupnea is normal breathing, and hyperventilation is breathing excessively fast or deep.