The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol). Which statement about this inhaler is accurate?

Correct Answer: D

Rationale: The correct answer is D because Advair inhaler contains fluticasone propionate (a steroid) and salmeterol (a long-acting bronchodilator) which work together to prevent bronchospasms. Fluticasone reduces inflammation in the airways, while salmeterol helps to relax the muscles around the airways. This combination is not meant for the treatment of acute bronchospasms (A), does not require a spacer for best results (B), and does not have any specific restrictions on drinking water after use (C).

Correct Answer: B

Rationale: The correct answer is B because a teratogenic action refers to substances or factors that can negatively affect the fetus during pregnancy, leading to fetal malformations or abnormalities. This is a well-established concept in the field of developmental biology and teratology. Options A, C, and D are incorrect as they do not specifically pertain to the impact on fetal development, which is the defining characteristic of teratogenic actions. Option A focuses on the liver, Option C on the blood system, and Option D on the kidneys, none of which directly relate to the concept of teratogenicity.

Correct Answer: A

Rationale: The correct answer is A because bupivacaine is known for its high cardiotoxicity compared to other local anesthetics. This is due to its ability to cause cardiac arrhythmias at lower doses. Choice B is correct as bupivacaine does have an amide linkage. Choice C is correct as it is a long-acting drug, providing prolonged anesthesia. Choice D is correct as an intravenous injection of bupivacaine can indeed lead to seizures due to its central nervous system toxicity.

Correct Answer: D

Rationale: Atropine is rarely used for peptic ulcer treatment due to its adverse effects, which include slow gastric emptying leading to prolonged exposure of the ulcer bed to acid, low efficiency requiring large doses, and other possible side effects. Therefore, the correct answer is D as it encompasses all the reasons why atropine is not commonly used for peptic ulcer treatment. Choices A, B, and C individually address specific drawbacks of atropine, but only D covers all the reasons comprehensively.

Correct Answer: B

Rationale: The correct answer is B: α2 receptor. Epinephrine binds to α2 receptors, leading to inhibition of adenylate cyclase activity, which decreases intracellular cAMP levels. α1 receptors are Gq-coupled and increase intracellular calcium levels. Beta1 receptors are also Gs-coupled, leading to increased cAMP levels. Beta2 receptors, like α2 receptors, are Gi-coupled and decrease cAMP levels. Therefore, the correct answer is B because epinephrine acts on α2 receptors to decrease cAMP levels.