The home health nurse notes that the elderly patient doubled up on his pain medication, even though the prescribed dose was at a therapeutic level. The patient says, 'If one pill is good, two pills are better.' Which statement best describes the result of the patient's action?

Correct Answer: D

Rationale: Doubling a therapeutic dose exceeds the plateau-efficacy maxes out, but side effects (e.g., sedation) rise with excess, especially in the elderly with slower clearance. Tolerance needs chronic use, not one event. More relief assumes linear gain, not true. Tolerance requiring more is future, not immediate. Side effects reflect pharmacodynamics, a key risk.

Correct Answer: D

Rationale: Weight loss, tachycardia, and goitre suggest hyperthyroidism (e.g., Graves'). Verapamil controls rate but not thyroid function. Radioactive iodine (131I) treats long-term, not immediately. Carbamazepine is for seizures, L-thyroxine worsens hyperthyroidism. Atenolol, a beta-blocker, immediately reduces tachycardia and symptoms by blocking adrenergic effects, suitable for acute management while awaiting antithyroid drugs (e.g., propylthiouracil). Its symptomatic relief is critical in hyperthyroid crises.

Correct Answer: D

Rationale: Angiotensin-converting enzyme (ACE) inhibitors, a type of angiotensin inhibitor, may have a serious interaction with nonsteroidal anti-inflammatory drugs (NSAIDs). This interaction can potentially reduce the effectiveness of the ACE inhibitor in lowering blood pressure and may cause kidney damage in susceptible individuals. Therefore, it is crucial for the nurse to be aware of this potential drug interaction and to monitor the patient for any signs of adverse effects when these two drug classes are used together.

Correct Answer: C

Rationale: Drug B, as an inducer of the cytochrome p-450 system, increases the metabolism of Drug A, leading to lower plasma concentrations and reduced therapeutic effects of Drug A. This interaction is a common concern in polypharmacy, where one drug affects the metabolism of another. Monitoring for decreased efficacy of Drug A is essential to ensure the patient receives adequate treatment. Increased adverse effects of Drug B or decreased effects of Drug B are less likely in this scenario.

Correct Answer: D

Rationale: Phenytoin is an antiepileptic medication that is used to control seizures. One of the common side effects of phenytoin is the development of tremors, which are involuntary shaking movements of the body. Patients taking phenytoin may experience tremors as a result of the medication's effects on the central nervous system. It is important for healthcare providers to monitor patients taking phenytoin for the development of tremors and manage them accordingly.