The nurse enters a patient’s room to find that his heart rate is 120, his blood pressure is 70/50, and he has red blotching of his face and neck. Vancomycin is running intravenous piggyback. The nurse believes that this patient is experiencing a severe adverse effect called red man syndrome. What action will the nurse take?

Correct Answer: A

Rationale: Red man syndrome is a hypersensitivity reaction to vancomycin, characterized by flushing, rash, hypotension, and tachycardia. The nurse should immediately stop the infusion to prevent further reaction and call the health care provider for further instructions. Reducing the infusion rate may help in mild cases, but in this severe case, stopping the infusion is the priority. Encouraging fluids is not appropriate for managing this acute reaction. Stevens-Johnson syndrome is a different, more severe condition and is not indicated by these symptoms.

Correct Answer: A

Rationale: A patient arriving in the emergency department with severe chest pain and a history of episodic chest pain over the past week may be experiencing a myocardial infarction or other serious cardiac event. Nitrates and nitrites are commonly used to manage chest pain in such situations because they help dilate blood vessels, improve blood flow to the heart, and reduce the workload on the heart.

Correct Answer: A

Rationale: Red man syndrome is a hypersensitivity reaction to vancomycin, characterized by flushing, rash, hypotension, and tachycardia. The nurse should immediately stop the infusion to prevent further reaction and call the health care provider for further instructions. Reducing the infusion rate may help in mild cases, but in this severe case, stopping the infusion is the priority. Encouraging fluids is not appropriate for managing this acute reaction. Stevens-Johnson syndrome is a different, more severe condition and is not indicated by these symptoms.

Correct Answer: B

Rationale: When administering the anticoagulant drug Warfarin, one of the two lab tests you should monitor to distinguish the effectiveness of the drug is the International Normalized Ratio (INR). INR measures the time it takes for blood to clot and is used to monitor the effects of Warfarin therapy. The target INR range for patients on Warfarin therapy varies depending on the indication for treatment, but in general, a higher INR indicates that the blood is taking longer to clot, which means the Warfarin is working effectively to prevent blood clots. Regular monitoring of the INR levels is essential to ensure that patients are receiving an appropriate dose of Warfarin to prevent both clotting and bleeding complications.

Correct Answer: B

Rationale: Nausea, vomiting, and diarrhea are signs of colchicine toxicity, which can be life-threatening. The client should stop taking the medication and notify the physician immediately. Continuing the medication or adjusting the dose without medical advice can exacerbate the toxicity. Colchicine has a narrow therapeutic index, and close monitoring is required to prevent adverse effects.

Correct Answer: D

Rationale: The volume of distribution (Vd) is a pharmacokinetic parameter that describes the relationship of the blood concentration attained with initial dosing and the dose of drug given. It is a theoretical volume that indicates the extent of drug distribution in the body relative to its concentration in the bloodstream. A high volume of distribution suggests that the drug is extensively distributed throughout the tissues of the body, while a low volume of distribution indicates that the drug is largely confined to the bloodstream. Therefore, Vd is the correct answer in this scenario.

Correct Answer: B

Rationale: Omeprazole is a proton pump inhibitor commonly used to reduce stomach acid production. One of the side effects of omeprazole is a change in stomach pH. By inhibiting the proton pumps in the stomach lining, omeprazole reduces the production of acid, leading to an increase in the pH level of the stomach. This change in stomach pH can affect the overall balance of acidity in the stomach and may result in various gastrointestinal symptoms such as bloating, gas, or changes in digestion. It is important for individuals taking omeprazole to be aware of this potential side effect and consult their healthcare provider if they experience any unusual symptoms.

Correct Answer: D

Rationale: The correct explanation for the prescription of the ACE inhibitor lisinopril for a patient with diabetes who does not have hypertension is that this medication has cardioprotective properties. ACE inhibitors, such as lisinopril, have been shown to have beneficial effects beyond just lowering blood pressure. They have been found to reduce the risk of cardiovascular events and complications in patients with diabetes, even in the absence of hypertension. Therefore, the prescription of lisinopril for a patient with diabetes may be for its cardioprotective properties rather than for hypertension control.

Correct Answer: B

Rationale: Pharmacology's complexity means learning is ongoing-new drugs, research, and applications evolve, preventing full mastery and requiring continuous growth. Applying knowledge is true but assumes completion. Painful learning dismisses positivity. Graduate courses are premature. Gradual learning reflects the field's dynamic nature, preparing the student for lifelong education, a realistic and encouraging perspective.