Phenobarbital (luminal) is given to a client for a short treatment of anxiety. Which of the following results would indicate a therapeutic serum range of the medication?

Correct Answer: A

Rationale: The therapeutic serum range for phenobarbital (luminal) when used for anxiety is typically between 5-10 mcg/ml. This range is considered effective in controlling anxiety symptoms while minimizing the risk of toxicity. Higher serum levels (options B, C, D) may increase the risk of adverse effects such as sedation, respiratory depression, and overdose. Therefore, monitoring the serum levels of phenobarbital is essential to ensure the medication is at a therapeutic range for the intended treatment.

Correct Answer: D

Rationale: The therapeutic range for lithium is generally considered to be 0.6-1.2 mmol/L (which is equivalent to 0.6-1.2 mEq/L). However, some sources may state a slightly wider range of 0.5-1.5 mEq/L. It is important to note that individual patient factors and clinical judgment should also be considered when interpreting lithium levels. Levels below the therapeutic range may be subtherapeutic and not provide the desired therapeutic effect, while levels above the range may result in toxicity and adverse effects. Monitoring lithium levels regularly is important to ensure they remain within the therapeutic range.

Correct Answer: C

Rationale: Montelukast is commonly administered orally, which stands for "per os" meaning by mouth. This medication is available in tablet, chewable tablet, and oral granule formulations for easy ingestion. It is not administered intravenously (IV), intramuscularly (IM), or subcutaneously (SubQ) as it is primarily used for oral administration to treat asthma and allergic rhinitis.

Correct Answer: B

Rationale: Idiosyncratic reactions to drugs refer to individual responses that cannot be explained by known mechanisms or understood pharmacological properties of the drug. These reactions are typically unpredictable and uncommon. Unlike allergic reactions that involve a specific immune response, idiosyncratic reactions are unique to the individual and may not be fully understood. Side effects, on the other hand, are known and expected effects of a drug, while teratogenic effects are related to drug exposure during pregnancy causing harm to the fetus.

Correct Answer: D

Rationale: The diagnostic triad of morphine overdose includes coma, depressed respiration, and pinpoint pupils. Coma occurs due to the central nervous system depression caused by morphine. Depressed respiration is a common symptom of opioid overdose, leading to respiratory distress and potential respiratory failure. Pinpoint pupils, also known as miosis, are a classic sign of opioid overdose and result from the effect of morphine on the autonomic nervous system. These three symptoms together are characteristic of a morphine overdose and indicate a medical emergency that requires prompt treatment.