The chemotherapeutic DNA alkylating agents such as nitrogen mustards are effective because they:

Correct Answer: A

Rationale: Chemotherapeutic DNA alkylating agents, such as nitrogen mustards, work by forming covalent bonds between alkyl groups on the drug and DNA strands. This cross-linking interferes with DNA replication and transcription, ultimately leading to cell death. This mechanism of action makes the alkylating agents effective in targeting rapidly dividing cancer cells.

Correct Answer: D

Rationale: Spironolactone is a potassium-sparing diuretic that works by promoting potassium retention in the body. Therefore, patients taking spironolactone are at a higher risk of developing hyperkalemia, which is an elevated level of potassium in the blood. Hyperkalemia can lead to serious complications such as cardiac arrhythmias, muscle weakness, and even cardiac arrest. It is important for the nurse to monitor patients on spironolactone for signs and symptoms of hyperkalemia, such as weakness, numbness, tingling, or an irregular heartbeat. Other diuretics like hydrochlorothiazide (A), furosemide (B), and acetazolamide (C) do not typically cause hyperkalemia as they work to decrease potassium levels in the body.

Correct Answer: C

Rationale: Palpitations are a late manifestation of hypokalemia. Hypokalemia is a condition characterized by low levels of potassium in the blood. Potassium plays a vital role in maintaining normal heart function. When potassium levels are low, it can lead to abnormal heart rhythms, including palpitations. Other symptoms of hypokalemia, such as muscle weakness, lethargy, and even hypotension, may be present before palpitations occur. Therefore, palpitations are considered a late manifestation of hypokalemia that signals significant potassium depletion and should be addressed promptly to prevent serious cardiac complications.

Correct Answer: B

Rationale: HMG-CoA reductase inhibitors, also known as statins, are a class of antilipemic drugs commonly prescribed to lower cholesterol levels. One side effect associated with statin use is myopathy, which manifests as muscle pain, tenderness, or weakness. In severe cases, myopathy can progress to rhabdomyolysis, a condition characterized by muscle breakdown and release of muscle fiber contents into the blood, potentially leading to kidney damage. It is essential for healthcare providers, such as nurses, to monitor patients on statin therapy for signs and symptoms of myopathy to intervene promptly if necessary. Niacin, fibric acid derivatives, and bile acid sequestrants are not typically associated with myopathy as a common side effect.

Correct Answer: D

Rationale: Clopidogrel is a drug that has a therapeutic effect in preventing thromboembolic events. It is an antiplatelet agent that works by inhibiting platelet aggregation, thus reducing the risk of blood clot formation. Clopidogrel is commonly used in patients at risk for cardiovascular events such as heart attacks and strokes. Warfarin is an anticoagulant medication that also helps prevent blood clots, but it works by a different mechanism than clopidogrel. Amlodipine is a calcium channel blocker used to treat hypertension and angina, while nitroglycerine is a vasodilator used in the treatment of angina.