The nurse administers medications by various routes of delivery. The nurse recognizes which route of administration as requiring higher dosages of drugs to achieve a therapeutic effect?

Correct Answer: B

Rationale: Rationale: The correct answer is B) Oral route. When drugs are administered orally, they have to pass through the gastrointestinal tract before entering the bloodstream. This process, known as the first-pass effect, can lead to a significant portion of the drug being metabolized or excreted before reaching systemic circulation, thus requiring higher dosages to achieve a therapeutic effect. Intravenous (A) route delivers medications directly into the bloodstream, bypassing the first-pass effect, resulting in immediate and full drug availability at the target site, hence requiring lower dosages for efficacy. Rectal (C) and sublingual (D) routes also bypass the first-pass effect to some extent, but they have smaller absorption surfaces compared to the gastrointestinal tract, making them less efficient in drug absorption than the oral route. However, they still generally require lower dosages compared to the oral route due to more direct absorption. Educational context: Understanding the different routes of drug administration and their pharmacokinetic implications is crucial for nurses in providing safe and effective care to clients. Knowledge of which routes require higher dosages to achieve therapeutic effects helps nurses in accurate medication administration, dosage calculations, and monitoring for desired outcomes and potential adverse effects. This question highlights the importance of considering pharmacokinetic factors when determining appropriate dosages for different routes of drug administration.

Correct Answer: D

Rationale: The best response by the nursing instructor is option D: "It will help to individualize drug therapy for people in a more effective way." This response is correct because the Human Genome Project has provided valuable insights into how genetic variations can impact an individual's response to medications. By understanding a person's genetic makeup, healthcare providers can tailor pharmacological treatments to be more effective and reduce the risk of adverse reactions. Option A is incorrect because altering genes to eliminate the need for drugs is overly simplistic and not currently feasible with our current understanding of genetics and pharmacology. Option B is incorrect because while standardizing drug doses may have some benefits in prescribing practices, it does not directly address the potential for personalized medicine based on genetic information. Option C is incorrect because the Human Genome Project does have the potential to not only help prevent disease through gene manipulation but also significantly impact pharmacological therapies by guiding personalized treatment approaches. In an educational context, it is essential for nursing students to understand the implications of genetic research on pharmacological therapies. As precision medicine becomes more prevalent, nurses need to be aware of how genetic factors can influence drug responses and how individualized treatment plans can improve patient outcomes. Understanding this connection is crucial for providing safe and effective care to clients across the lifespan.

Correct Answer: D

Rationale: In pharmacology, the therapeutic index (TI) is a crucial concept that helps determine the safety of a medication. It is calculated by dividing the median lethal dose (LD50) by the median effective dose (ED50). A higher TI indicates a safer drug because the effective dose is much lower than the lethal dose. In this scenario, the nurse is calculating the therapeutic index of the medication by dividing the LD50 of $40 mg$ by the ED50 of $10 mg$, resulting in a TI of 4. This means that the medication is relatively safe since the effective dose is four times lower than the lethal dose. For the options: - Option A, B, and C cannot be evaluated as they are not provided. - Option D is correct because it aligns with the calculated TI of 4 based on the LD50 and ED50 given in the question. Understanding the therapeutic index is vital for nurses as it guides them in administering medications safely, ensuring the right dosage is given to achieve therapeutic effects without causing harm. Nurses must be aware of medications' TI to prevent adverse effects and provide optimal care to patients across the lifespan.

Correct Answer: A

Rationale: The correct answer is A) The adolescent says, 'Everyone makes a big deal about what I eat, so don’t ask.' This statement indicates a potential body image concern as it suggests the adolescent is sensitive to comments about their eating habits, which is often linked to body image issues in adolescents. Body image concerns are common during this developmental stage due to societal pressures and expectations regarding appearance. Option B) The adolescent telling the nurse about being sexually active with their boyfriend is more indicative of sexual health concerns rather than body image issues. Option C) where the adolescent mentions irregular periods, points towards a possible gynecological or hormonal issue rather than body image concerns. Option D) where the adolescent mentions conflicts with parents suggests family dynamics issues rather than body image concerns. In an educational context, it's crucial for school nurses and healthcare providers to be able to recognize signs and symptoms of body image concerns in adolescents as early intervention and support can be pivotal in preventing more serious issues like eating disorders or mental health struggles. Understanding the nuances of adolescent communication and behavior is essential in identifying underlying issues and providing appropriate care and support.

Correct Answer: C

Rationale: In the context of pharmacological treatments during pregnancy and lactation, the correct answer is C) sexually transmitted infections. This is because untreated sexually transmitted infections (STIs) can have serious consequences for both the pregnant person and the developing fetus. Managing STIs with appropriate drug therapy is crucial to prevent complications such as preterm birth, low birth weight, and neonatal infections. Option A) epilepsy: While epilepsy requires careful management of medications during pregnancy to balance the risks to the mother and the fetus, drug therapy is often adjusted rather than postponed due to the potential risks associated with uncontrolled seizures. Option B) serious cystic acne: Although some acne medications are not recommended during pregnancy, they are generally not considered as critical to manage as conditions like STIs or epilepsy during this time. Option D) gestational diabetes: Gestational diabetes is typically managed through dietary changes and lifestyle modifications first, with drug therapy being considered if these measures are insufficient. Postponing drug therapy for gestational diabetes is often a viable option if blood sugar levels can be managed effectively through other means. Educationally, understanding the prioritization of pharmacological treatments during pregnancy and lactation is crucial for healthcare providers working with pregnant individuals. It highlights the importance of weighing the risks and benefits of drug therapy for various conditions to ensure the best possible outcomes for both the mother and the developing fetus.