The NP student is concerned than an older patient's adverse drug reactions are due to reduced renal excretion. Which laboratory result should be closely monitor?

Correct Answer: C

Rationale: The correct answer is C: Creatinine clearance. Creatinine clearance is the most accurate indicator of renal function as it directly measures the glomerular filtration rate. Monitoring creatinine clearance helps assess the kidney's ability to filter waste products. Serum creatinine levels (A) can be influenced by factors other than renal function. Serum albumin levels (B) reflect protein status, not renal function. Blood urea nitrogen (BUN) (D) can be affected by factors other than renal function, such as protein intake and liver function. Therefore, creatinine clearance is the best option for monitoring renal excretion in older patients.

Correct Answer: D

Rationale: The correct answer is D: Genital infections. Fluoroquinolone antibiotics are commonly used to treat bacterial infections in the genital area due to their broad spectrum of activity against various types of bacteria commonly implicated in these infections. They are effective against pathogens such as Chlamydia, Gonorrhea, and other sexually transmitted infections. A: Asthma - Fluoroquinolones are not indicated for the treatment of asthma as they are not effective against the underlying causes of asthma such as inflammation and bronchoconstriction. B: Follicular conjunctivitis - While fluoroquinolones can be used topically in the eye for certain eye infections, they are not typically indicated for follicular conjunctivitis which often requires different types of antibiotics. C: GERD - Fluoroquinolones are not used to treat GERD (Gastroesophageal Reflux Disease) which is a condition related to stomach acid reflux into the esophagus. Antacids

Correct Answer: B

Rationale: The correct answer is B: Parental Ceftriaxone. Ceftriaxone is recommended for treating gonorrhea due to increasing resistance to other antibiotics. It provides broad-spectrum coverage and high efficacy. The other choices are incorrect because: A: Cephalexin is not the first-line treatment for gonorrhea. C: Ciprofloxacin is no longer recommended due to high resistance rates. D: Penicillin is not effective against gonorrhea due to widespread resistance.

Correct Answer: A

Rationale: Step-by-step rationale for why Answer A is correct: 1. Desensitization, internalization, and downregulation of receptors can lead to tolerance by reducing the responsiveness of receptors to a drug. 2. Higher drug doses are needed to achieve the same effect due to decreased receptor sensitivity. 3. Enhanced drug elimination can reduce drug concentrations, requiring higher doses to achieve the desired response. 4. Therefore, the statement accurately describes the mechanisms of tolerance development. Summary: Choice A is correct because it accurately explains how desensitization, internalization, downregulation of receptors, and enhanced drug elimination can contribute to the development of tolerance. Choices B, C, and D are incorrect as they do not provide a comprehensive explanation of tolerance mechanisms.

Correct Answer: A

Rationale: The correct answer is A: Enoxaparin. Enoxaparin is a low molecular weight heparin commonly used for thrombosis prophylaxis in pregnant patients due to its safety profile. It does not cross the placenta, reducing the risk of fetal bleeding. Alteplase (B) is a thrombolytic agent used for acute thrombotic events, not prophylaxis. Clopidogrel (C) is an antiplatelet drug and not recommended during pregnancy due to potential fetal harm. Warfarin (D) is contraindicated in pregnancy due to teratogenic effects and risks of fetal bleeding.