The nurse is reviewing the orders for a patient and notes a new order for an angiotensin-converting enzyme (ACE) inhibitor. The nurse checks the current medication orders, knowing that this drug class may have a serious interaction with what other drug class?

Correct Answer: C

Rationale: The correct answer is C: Nonsteroidal antiinflammatory drugs (NSAIDs). ACE inhibitors can increase the risk of kidney damage when taken with NSAIDs due to their combined effects on renal function. NSAIDs can interfere with the vasodilatory effects of ACE inhibitors, potentially leading to decreased renal blood flow and worsened kidney function. Calcium channel blockers (A), diuretics (B), and nitrates (D) do not have the same significant interaction with ACE inhibitors as NSAIDs do.

Correct Answer: C

Rationale: The correct answer is C: Intramuscular injection using the Z-track method. This method helps prevent leakage of the medication into surrounding tissues and minimizes irritation. Step-by-step rationale: 1. Clean the injection site. 2. Pull the skin laterally to create a zig-zag path. 3. Administer the injection deep into the muscle. 4. Hold the needle in place for a few seconds before removing. Summary: A is incorrect because iron dextran is not typically administered intravenously. B is incorrect as intramuscular injections without the Z-track method can lead to leakage and irritation. D is incorrect as iron dextran injections are not given subcutaneously.

Correct Answer: B

Rationale: The correct answer is B because elimination is defined as the clearance speed of a substance from the blood, indicating how efficiently the kidneys remove a substance from the bloodstream over a given period. This process is quantified by measuring the volume of blood cleared of the substance per unit time. Choices A, C, and D do not directly refer to the process of elimination as described, making them incorrect. Choice A refers to reabsorption, not elimination. Choice C describes half-life, not elimination rate. Choice D refers to clearance of a xenobiotic from an organism, which is related but not the precise definition of elimination in the context of pharmacokinetics.

Correct Answer: C

Rationale: The correct answer is C: The ability to diffuse to the site of action. Ionizable groups in a molecule can influence its ability to cross cell membranes and reach the target site. Potency and toxicity (choice A) are determined by the molecule's interaction with the target, not just ionizable groups. Duration of action (choice B) can be affected by various factors, not solely ionizable groups. Choice D is incorrect because ionizable groups do not directly impact potency, toxicity, and duration of action simultaneously.

Correct Answer: A

Rationale: Step 1: Acetylcholine is a direct-acting cholinomimetic that quickly hydrolyzes by acetylcholinesterase, leading to a short duration of action. Step 2: Methacholine, Carbachol, and Bethanechol are also direct-acting cholinomimetics but are more resistant to enzymatic degradation, resulting in longer durations of action. Summary: Acetylcholine has the shortest duration of action due to rapid enzymatic degradation compared to the other choices. Methacholine, Carbachol, and Bethanechol have longer durations of action as they are more resistant to enzymatic degradation.