Sarah developed a rash after using a topical medication. This is a type __ allergic drug reaction.

Correct Answer: D

Rationale: Choice D is correct because a rash from topical medication is typically a type IV allergic reaction, a delayed hypersensitivity mediated by T-cells, common in skin responses. Choice A is incorrect as type I is immediate, like anaphylaxis, not a rash. Choice B is wrong because type II is cytotoxic, not skin-based. Choice C is incorrect since type III involves immune complexes, not topical rashes.

Correct Answer: A

Rationale: Choice A is correct because hypoalbuminemia lowers albumin levels, which bind drugs in plasma; this alters distribution to tissues, potentially increasing free drug concentrations and affecting efficacy or toxicity. Choice B is incorrect as solubility relates to absorption, not albumin binding. Choice C is wrong because less albumin means more free drug, not less, due to reduced binding. Choice D is incorrect since albumin-bound drugs are less readily excreted; lower binding prolongs drug presence in circulation.

Correct Answer: D

Rationale: Choice D is correct because Lexicomp offers dosing, Medline provides studies, and Beers Criteria lists risky drugs—all key for elderly prescribing. Choice A is incorrect alone as it's one tool. Choice B is wrong by itself because it's research-focused. Choice C is incorrect solo since Beers is specific.

Correct Answer: B

Rationale: Choice B is correct because ketamine is a Schedule III drug with moderate abuse potential and medical use (anesthetic), per DEA. Choice A is incorrect as oxycodone is Schedule II. Choice C is wrong because lorazepam is Schedule IV. Choice D is incorrect since only ketamine fits.

Correct Answer: D

Rationale: Choice D is correct because the elderly (age-related diseases), those with chronic conditions (multiple meds), and patients with multiple providers (uncoordinated care) are prone to polypharmacy, per research. Choice A is incorrect alone as it's one group. Choice B is wrong by itself because chronic conditions are just part. Choice C is incorrect solo since multiple providers are only one factor.

Correct Answer: A

Rationale: Choice A is correct because vitamin K deficiency reduces clotting factor synthesis, enhancing warfarin's anticoagulant effect, a direct drug action impact. Choice B is incorrect as vitamin C deficiency (scurvy) doesn't significantly alter drug action pharmacokinetically. Choice C is wrong because B12 deficiency affects neurology, not drug metabolism broadly. Choice D is incorrect since only vitamin K has a specific, notable drug interaction.

Correct Answer: D

Rationale: Choice D is correct because educating on temperature (efficacy), child safety (prevents ingestion), and humidity avoidance (stability) ensures proper drug storage, per safety guidelines. Choice A is incorrect alone as it's one aspect. Choice B is wrong by itself because safety is just part. Choice C is incorrect solo since humidity is only one concern.

Correct Answer: A

Rationale: Choice A is correct because spironolactone blocks androgen receptors, causing gynecomastia, a well-documented side effect. Choice B is incorrect as atenolol (beta blocker) rarely causes it. Choice C is wrong because lisinopril (ACE inhibitor) doesn't typically lead to gynecomastia. Choice D is incorrect since only spironolactone is a clear culprit.

Correct Answer: D

Rationale: The correct answer is D because a thorough history is needed as diet, alcohol, smoking, and supplements can affect drug kinetics beyond other medications. Choice A is incorrect as CYP450 can still be influenced. Choice B is wrong since past alcohol use affects liver function. Choice C is inaccurate as food interactions are broader.