The nurse is reviewing drug therapy for hypertension. According to the JNC 7 guidelines, antihypertensive drug therapy for a newly diagnosed stage 1 hypertensive African-American patient would most likely include which drug or drug classes?

Correct Answer: C

Rationale: The correct answer is C: Calcium channel blockers with thiazide diuretics. This combination is recommended for African-American patients with hypertension according to the JNC 7 guidelines. Calcium channel blockers are effective in this population due to their ability to improve blood pressure control. Thiazide diuretics are also effective and can further reduce blood pressure when combined with calcium channel blockers. Choice A (Vasodilators alone) is not typically recommended as first-line therapy. Choice B (ACE inhibitors alone) may be less effective in African-American patients. Choice D (Beta blockers with thiazide diuretics) is not the preferred combination for this patient population based on current guidelines.

Correct Answer: D

Rationale: The correct answer is D, Hepatic impairment. Antitubercular drugs are primarily metabolized by the liver, so hepatic impairment can affect drug metabolism, leading to toxicity or reduced efficacy. Glaucoma (A), anemia (B), and heart failure (C) are not direct contraindications to antitubercular therapy. Glaucoma does not affect drug metabolism, anemia does not interfere with drug efficacy, and heart failure does not directly impact antitubercular drugs' effectiveness.

Correct Answer: A

Rationale: The correct answer is A: Faster urinary excretion. Biotransformation involves converting a drug into metabolites that are more easily excreted by the body, primarily through urine. This process increases the water solubility of the drug, allowing it to be eliminated more efficiently. Option B is incorrect because biotransformation typically leads to faster, not slower, urinary excretion. Option C is incorrect as biotransformation does not affect distribution within the organism. Option D is incorrect because biotransformation does not directly impact the binding of the drug to membranes.

Correct Answer: A

Rationale: The correct answer is A because the therapeutic index (TI) is a ratio that measures the safety of a drug by comparing the dose that produces therapeutic effects to the dose that causes toxicity. This ratio helps determine the margin of safety of a drug for a specific indication. Choice B is incorrect because TI does not directly measure effectiveness. Choice C is incorrect as bioavailability is a different concept related to drug absorption. Choice D is incorrect because TI focuses on safety and not drug elimination. Therefore, A is the correct answer as it accurately reflects the purpose of the therapeutic index.

Correct Answer: A

Rationale: The correct answer is A: Heart. M2 cholinoreceptors are primarily located in the heart. These receptors are involved in regulating heart rate and contractility by inhibiting adenylate cyclase activity. This leads to decreased cAMP levels, resulting in a decrease in heart rate and contractility. The other choices (B: Glands, C: Smooth muscle, D: Endothelium) are incorrect as M2 receptors are not typically found in these locations. In glands, M3 receptors are more common, in smooth muscle M3 receptors predominate, and in the endothelium, muscarinic receptors are not the primary receptors involved in regulation.