The nurse is discouraged because his plan to reduce negative symptoms of schizophrenia (apathy, avolition, inattentiveness, poor socialization, poor eye contact and flat affect, etc.) in a client is not working. The mentor’s remark that helps place the problem in perspective is:

Correct Answer: C

Rationale: The correct answer is C: "Negative symptoms have been associated with prefrontal cortical pathology." This is the most appropriate response because it provides a scientific explanation for the nurse's difficulty in reducing the negative symptoms of schizophrenia. Negative symptoms in schizophrenia, such as apathy and inattentiveness, are believed to be related to dysfunction in the prefrontal cortex of the brain. Understanding this underlying pathology helps the nurse approach the situation with a more informed perspective. Choice A is incorrect because it does not address the specific issue of negative symptoms in schizophrenia and does not provide any helpful insight for the nurse. Choice B is incorrect as it suggests a simplistic view of clients being stubborn, which does not consider the complex neurobiological factors at play in schizophrenia. Choice D is incorrect because while it acknowledges the role of psychosocial and environmental factors, it does not address the specific neuropathology associated with negative symptoms in schizophrenia.

Correct Answer: B

Rationale: The correct answer is B because Amiodarone (Cordarone) is classified as a class III antidysrhythmic drug which acts by prolonging the action potential duration. This leads to prolongation of the refractory period of the heart, helping to prevent reentry of arrhythmias. Choice A is incorrect as blocking slow calcium channels is the mechanism of action for class IV drugs. Choice C is incorrect as blocking sodium channels is the mechanism for class I drugs. Choice D is incorrect as decreasing spontaneous depolarization is the mechanism for class II drugs.

Correct Answer: A

Rationale: The correct answer is A: Force fluids to help loosen and liquefy secretions. Guaifenesin is an expectorant that works by thinning and loosening mucus in the airways, making it easier to cough up secretions. By instructing the patient to increase fluid intake, it helps enhance the medication's effect by keeping the secretions moist and easier to expel. Reporting clear-colored sputum (choice B) is not necessary as it is a normal sign of the medication working. Avoiding driving or operating heavy machinery (choice C) is not relevant as guaifenesin does not have sedating effects. Reporting symptoms lasting longer than 2 days (choice D) is important, but not directly related to the medication's mechanism of action.

Correct Answer: B

Rationale: The correct answer is B because absorption of drugs taken orally depends on the secretion and motor function of the gastrointestinal (GI) tract. This is because the drug needs to be properly broken down and absorbed through the GI tract before entering the bloodstream. Other choices are incorrect because: A: Fast onset of effect is more characteristic of routes like intravenous or inhalation. C: A drug reaching the blood passing the liver is more characteristic of the hepatic first-pass effect, not specific to the oral route. D: Sterilization of medicinal forms is not obligatory for the oral route, as proper storage and handling can ensure safety.

Correct Answer: B

Rationale: The correct answer is B: Cumulative effect. Continuous or repeated intake of a drug can lead to the accumulation of the drug in the body, causing a higher concentration than intended, leading to toxic reactions. Refractoriness (A) refers to decreased response to a drug over time. Tolerance (C) is the need for higher doses to achieve the same effect, not necessarily leading to toxicity. Tachyphylaxis (D) is a rapid decrease in response to a drug with repeated administration, not directly related to toxicity.