The client comes to the emergency department with a myocardial infarction. The client’s husband tells the nurse that his wife has been taking calcium carbonate (Tums) for years for what she thought was indigestion. What is the best response by the nurse?

Correct Answer: D

Rationale: The correct response, option D, is the best choice because it addresses the issue of self-diagnosis in a non-judgmental manner while also emphasizing the importance of seeking medical advice. In this scenario, the nurse needs to educate the husband on the potential risks associated with self-diagnosing and self-medicating, especially in the case of serious conditions like a myocardial infarction. By acknowledging the situation without assigning blame, the nurse opens the door for further discussion about the importance of professional medical evaluation and management. Option A is incorrect because it lacks empathy and does not offer any constructive advice or information. Option B is also inappropriate as it places unnecessary blame on the husband, which is not helpful in the current situation. Option C, though expressing relief that the client sought medical help, does not address the underlying issue of self-diagnosis and misses an opportunity for education. In an educational context, this scenario highlights the importance of effective communication and patient education in healthcare. Nurses play a crucial role in not only providing care but also in educating patients and their families about the risks of self-diagnosis and the importance of seeking professional medical help. By choosing option D, the nurse demonstrates empathy, professionalism, and a commitment to patient safety through education.

Correct Answer: C

Rationale: The best response by the nurse is option C) No, it could be excreted in your milk and affect the baby. St. John’s wort is a herbal supplement commonly used for mild depression, but it can potentially be excreted in breast milk, exposing the baby to its effects. This response prioritizes the safety of the nursing baby, which is crucial in pharmacological decisions for lactating mothers. Option A is incorrect because there is no evidence to suggest that St. John’s wort will cause the baby to have more allergies. Option B is incorrect as there is limited research on the effect of St. John’s wort on milk production. Option D is incorrect as there is no substantial evidence to support that St. John’s wort will affect the taste of breast milk and lead to rejection by the baby. In an educational context, it is important for nurses to be knowledgeable about pharmacological substances that can affect breastfeeding mothers and their infants. Providing accurate information to nursing mothers can help them make informed decisions that promote the health and safety of both themselves and their babies. This scenario highlights the importance of considering pharmacological effects on breastfeeding when counseling nursing mothers.

Correct Answer: B

Rationale: The correct answer is B) Some medications are excreted in the feces while others can be recirculated to the liver many times. This statement is accurate because some medications undergo enterohepatic circulation, where they are excreted in the bile, then reabsorbed in the intestines and transported back to the liver, extending their duration of action in the body. Option A is incorrect because not all medications secreted in bile are solely excreted in the feces; some may undergo enterohepatic circulation. Option C is incorrect as medications are metabolized in the liver, not the gallbladder. Option D is incorrect as many drugs are indeed excreted in the bile. Understanding the fate of drugs excreted in bile is crucial in pharmacology, as it impacts drug effectiveness, duration of action, and potential for drug-drug interactions. This knowledge is essential for healthcare professionals to ensure optimal drug therapy outcomes and minimize adverse effects.

Correct Answer: B

Rationale: The correct answer is B) Morphine is more potent than codeine; a lesser dose will be required. This statement reflects the nurse's understanding of the potency of narcotics. Morphine is indeed more potent than codeine, meaning it is more effective at relieving pain, and hence a lesser dose of morphine would be needed compared to codeine to achieve the desired pain relief effect. Option A is incorrect because potency is not related to causing allergic reactions, but rather to the strength of the drug. Option C is incorrect as it states that morphine produces more adverse effects, which is not necessarily true solely based on potency. Option D is incorrect because codeine can still relieve pain, but morphine is more potent in this regard. In an educational context, understanding the potency of different narcotics is crucial for healthcare professionals to administer the appropriate dose for pain management. This knowledge ensures effective pain relief while minimizing the risk of adverse effects associated with opioid use. It also emphasizes the importance of accurate medication administration based on the specific characteristics of each drug.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Drug Y is more potent, and drug X has a higher efficacy. Drug potency refers to the amount of drug needed to produce a specific effect, while efficacy is the maximum effect a drug can produce. In this case, drug X achieves a greater maximum drop in cholesterol (higher efficacy) compared to drug Y. However, drug Y achieves this effect at a lower dose (higher potency) than drug X. Therefore, drug Y is more potent because it achieves a significant drop in cholesterol at a lower dose, while drug X has a higher efficacy as it can produce a greater maximum drop in cholesterol. Understanding the concepts of potency and efficacy is crucial in pharmacology as it helps in selecting the most appropriate drug doses for different patient populations based on desired effects and safety profiles.