The nurse is reviewing the medical record of a patient before giving a new order for iron sucrose (Venofer). Which statement regarding the administration of iron sucrose is correct?

Correct Answer: D

Rationale: The correct answer is D because monitoring for hypotension during iron sucrose infusion is crucial due to the risk of anaphylactic reactions. Hypotension is a common early sign of an allergic reaction. Choices A and B are incorrect as iron sucrose is typically given on an empty stomach and is safe for patients with renal disease. Choice C is incorrect as a test dose is not usually required for iron sucrose administration.

Correct Answer: B

Rationale: The correct answer is B: Ultracaine. Ultracaine is a thiophene derivative because it contains a thiophene ring in its chemical structure. Thiophene is a five-membered heterocyclic compound containing sulfur. Procaine (A) is an ester local anesthetic, Lidocaine (C) is an amide local anesthetic, and Mepivacaine (D) is an amide local anesthetic. Therefore, they do not belong to the thiophene derivative class. Ultracaine is the only option that fits the description of being a thiophene derivative.

Correct Answer: B

Rationale: The correct answer is B: Edrophonium. Edrophonium is an indirect-acting cholinomimetic agent because it works by inhibiting acetylcholinesterase enzyme, leading to an increase in acetylcholine levels at the synaptic cleft. This results in enhanced cholinergic transmission. On the other hand, choices A, C, and D are direct-acting cholinomimetics. Lobeline (A) acts as a nicotinic receptor agonist, Pilocarpine (C) is a muscarinic receptor agonist, and Carbachol (D) is a non-selective cholinomimetic that directly stimulates both nicotinic and muscarinic receptors without affecting acetylcholinesterase. Therefore, Edrophonium is the only indirect-acting cholinomimetic among the provided options.

Correct Answer: C

Rationale: Hexamethonium is a ganglionic blocker that acts specifically at the autonomic ganglia. It inhibits the action of acetylcholine at the ganglionic nicotinic receptors, leading to the blockade of autonomic functions. This results in the inhibition of sympathetic and parasympathetic responses. Therefore, the correct answer is C: Autonomic ganglia. Muscarinic receptor site (A) is not directly affected by Hexamethonium. Neuromuscular junction (B) is not the primary site of action for this drug. Axonal transmission (D) is not the specific target of Hexamethonium.

Correct Answer: D

Rationale: The correct answer is D because epinephrine acts on different receptors to induce hyperglycemia. Epinephrine stimulates beta2 receptors to increase gluconeogenesis and glycogenolysis, leading to elevated blood glucose levels. It also inhibits insulin secretion from alpha receptors, further contributing to hyperglycemia. Therefore, all options A, B, and C are correct mechanisms through which epinephrine induces hyperglycemia.