The foundation of clinical trials, Good Clinical Practice, is a helpful resource for nurses. The nurse is correct in choosing Good Clinical Practice as a reference for standards in which areas? (Select all that apply.)

Correct Answer: A

Rationale: The correct answer is A: Design. Good Clinical Practice (GCP) provides guidelines for the design of clinical trials to ensure ethical conduct, data integrity, and participant safety. It covers aspects such as study protocol development, participant selection, and informed consent procedures. Monitoring and auditing (B) are also covered by GCP, but they focus on oversight rather than design. Analyses (C) and reporting (D) are more related to data management and interpretation, which are not the primary focus of GCP's design guidelines. Therefore, the nurse should choose GCP as a reference for standards in the design of clinical trials.

Correct Answer: A

Rationale: The correct answer is A because drugs with a smaller volume of distribution tend to stay in the bloodstream longer, leading to a longer half-life. This is important for determining dosing intervals. Option B is incorrect because oral drugs are usually absorbed through passive diffusion or active transport, not pinocytosis. Option C is incorrect because patients with kidney disease may actually have more protein-binding sites, leading to potential drug accumulation. Option D is incorrect because rapid absorption typically increases the bioavailability of the drug, not decreases it.

Correct Answer: A

Rationale: The correct answer is A because it demonstrates understanding of the importance of dietary modifications in managing diabetes. By stating "I will no longer put sugar on my cereal because that will help me be healthier," the patient shows a willingness to make lifestyle changes to improve their health. This indicates a commitment to adhering to the prescribed treatment plan. Choice B is incorrect because it suggests the patient expects immediate relief and may stop taking the medication prematurely. Choice C is incorrect as it focuses on fear-based motivation rather than understanding the benefits of medication adherence. Choice D is incorrect as it reflects a fatalistic attitude that may hinder the patient's engagement in self-care.

Correct Answer: C

Rationale: The correct answer is C: It remains the same. Hepatic enzyme inducers can increase the metabolism of warfarin, leading to decreased levels. However, the dose adjustment is usually not necessary because the international normalized ratio (INR) can be monitored and the warfarin dose can be adjusted accordingly to maintain therapeutic levels. Increasing or decreasing the dose preemptively without INR monitoring can lead to adverse effects. Choice A is incorrect because increasing the dose can lead to over-anticoagulation. Choice B is incorrect as decreasing the dose can result in under-anticoagulation. Choice D is incorrect as the effect of hepatic enzyme inducers on warfarin metabolism is predictable, but the dose adjustment is based on INR monitoring.

Correct Answer: D

Rationale: Clopidogrel is an inhibitor of platelet aggregation, specifically an antiplatelet agent. It works by inhibiting the activation of platelets, preventing blood clot formation. This is important in conditions like heart attacks and strokes. A: Low-molecular-weight heparin is an anticoagulant, not an antiplatelet agent. B: Vitamin K antagonists like warfarin are anticoagulants, not antiplatelet agents. C: Direct thrombin inhibitors like dabigatran are anticoagulants, not antiplatelet agents. In summary, the correct answer is D because clopidogrel is an inhibitor of platelet aggregation, which distinguishes it from the other choices that are anticoagulants.