The nurse has a patient demonstrate self-administration of eyedrops. Place the steps in the order in which the patient will perform them.

Correct Answer: B

Rationale: The correct order for self-administering eyedrops is: 1. Wash hands (g). 2. Remove the cap (d). 3. Gently shake the bottle to evenly distribute the drug (b). 4. Tilt the head backward and look upward (e). 5. Pull the lower lid away from the eye so that a pouch is formed (a). 6. Place the dropper just above the pouch without touching the tip to the eye or finger (f). 7. Gently squeeze one drop of medicine into the pouch (h). 8. Press a finger against the inner corner of the eye for 2 to 3 minutes (c). This sequence ensures proper administration and minimizes the risk of contamination or systemic absorption.

Correct Answer: B

Rationale: Tricyclic antidepressants (TCAs) are associated with a high risk of toxicity in overdose, with cardiac arrhythmias being the most serious and life-threatening complication. TCAs can block sodium channels in the heart, leading to prolonged QRS intervals, ventricular tachycardia, and even cardiac arrest. Hyperpyrexia, seizures, and metabolic acidosis can also occur, but cardiac arrhythmias are the primary concern due to their potential to cause sudden death. Immediate medical intervention is required to manage TCA overdose, including cardiac monitoring and administration of sodium bicarbonate.

Correct Answer: A

Rationale: Renal failure alters drug clearance, requiring dose adjustments or avoidance. Prednisolone, a glucocorticoid, is metabolized hepatically to prednisone, with minimal renal excretion, making it safe without adjustment in renal failure. Netilmicin, an aminoglycoside, is renally cleared, risking ototoxicity if not reduced. Metformin, cleared renally, risks lactic acidosis in renal impairment, often avoided. Methotrexate, renally excreted, accumulates in failure, causing toxicity (e.g., marrow suppression). Tinzaparin, a low molecular weight heparin, requires adjustment due to renal clearance. Prednisolone's hepatic handling makes it the exception, safe for use in renal dysfunction without modification.

Correct Answer: B

Rationale: Amiodarone is a class III antiarrhythmic that affects sodium (Na+), potassium (K+), and calcium (Ca2+) channels, prolonging repolarization, so the statement excluding Ca2+ effects is false. It has antianginal effects by reducing myocardial oxygen demand through heart rate and afterload reduction, a true statement and its correct attribute. Its half-life is exceptionally long (weeks to months), not short, due to extensive tissue distribution, making that false. It decreases, not increases, peripheral resistance via vasodilation, so that's incorrect. It also affects the lungs, causing potential pulmonary toxicity, not minimal impact. The antianginal property is key to its use in angina alongside arrhythmias, reflecting its broad ion channel blockade and hemodynamic benefits, necessitating careful monitoring for side effects.

Correct Answer: A

Rationale: Anabolic steroids, synthetic testosterone derivatives, suppress natural hormone production, including spermatogenesis, leading to infertility-a critical risk for young athletes to understand. They also impact the entire body, notably causing liver damage (e.g., hepatotoxicity or tumors), a systemic effect worth noting. However, while effective for muscle growth, weight training surpasses steroids in safety and sustainability, debunking the ‘most effective' claim. Aggression, or ‘roid rage,' is a well-documented behavioral change due to hormonal imbalance, making it another key point. Infertility stands out in education, as it's a direct, long-term consequence tied to reproductive health, resonating with teens' future planning, and is supported by evidence of testicular atrophy and reduced sperm count, distinguishing it from broader effects or myths about efficacy.