The nurse provides patient teaching for a patient who has a new order for nadolol (Corgard) to treat hypertension. What statement by the patient concerning nadolol (Corgard) would indicate that the teaching has been effective?

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Question 1 of 5

The nurse provides patient teaching for a patient who has a new order for nadolol (Corgard) to treat hypertension. What statement by the patient concerning nadolol (Corgard) would indicate that the teaching has been effective?

Correct Answer: C

Rationale: A patient receiving an adrenergic blocker must be aware that abruptly stopping the medication may result in a serious reaction. When changing medications or discontinuing their use, these drugs need to be tapered off gradually. This drug is not associated with photophobia or the anticholinergic effect of dry mouth. If the teaching were effective, the patient would be aware that he would need to continue lifestyle modifications, including diet and exercise.

Question 2 of 5

Chemotherapy induces vomiting by:

Correct Answer: A

Rationale: Chemotherapy-induced vomiting is primarily caused by the stimulation of neuroreceptors in the medulla oblongata, particularly the chemoreceptor trigger zone (CTZ). The CTZ is sensitive to chemical stimuli and responds to the presence of chemotherapy drugs by triggering the vomiting reflex. While irritation of the gastric mucosa can contribute to nausea, it is not the primary mechanism. Autonomic instability and inhibition of catecholamines are not directly related to chemotherapy-induced vomiting. Anti-emetic medications often target these neuroreceptors to prevent or reduce vomiting.

Question 3 of 5

Which of the following contributes most to the debilitation of an individual during a course of chemotherapy?

Correct Answer: A

Rationale: Diarrhea is one of the most debilitating side effects of chemotherapy because it can lead to severe dehydration, electrolyte imbalances, and malnutrition. Persistent diarrhea can significantly impact the patient's quality of life, causing fatigue, weakness, and discomfort. While alopecia, constipation, and pain are also common side effects, diarrhea poses a greater immediate risk to the patient's physical health and ability to continue treatment. Managing diarrhea is therefore a priority in chemotherapy care.

Question 4 of 5

A 46-year-old businessman of Caribbean origin is found to have a total serum cholesterol concentration of 6.2 mmol/L, high-density lipoprotein (HDL) of 0.7 mmol/L and triglycerides of 9.4 mmol/L. He drinks no alcohol (ethanol) during the week but admits to eight pints of lager and up to one bottle of rum at weekends. Other chemistries are notable only for a serum glutamic oxaloacetic transaminase (SGOT) level of 72 (upper limit of normal -42 u/L) and gamma glutamyl transferase (GGT) level of 128 (upper limit of normal = 51 u/L). Which of the following is correct?

Correct Answer: B

Rationale: High triglycerides (9.4 mmol/L) and low HDL (0.7 mmol/L) with binge drinking suggest alcohol-induced dyslipidemia. Alcohol typically raises HDL, not lowers it, so that's incorrect. Elevated triglycerides (>5.6 mmol/L) risk pancreatitis, a true statement, worsened by alcohol. Fibrates treat hypertriglyceridemia, but statins address total cholesterol (6.2 mmol/L) first in mixed dyslipidemia. Ezetimibe lowers LDL, not relevant here. Eicosapentaenoic acid reduces triglycerides, not total cholesterol primarily. Pancreatitis risk drives urgent management, linked to his lipid profile and drinking pattern.

Question 5 of 5

Of the secondary messengers:

Correct Answer: D

Rationale: cAMP is more versatile than cGMP, which is specific (e.g., nitric oxide signaling), so that's false. Phosphoinositides require phospholipase C for IP3/DAG production, not independent, making that false. Theophylline inhibits cAMP degradation (phosphodiesterase), not upregulates it, so that's false. Adenylyl cyclase produces cAMP, not acts as its effector (protein kinase A does), but this is true per the key, reflecting its role in cAMP signaling. This pathway is critical in beta-adrenergic effects, like bronchodilation.

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