The patient has been receiving amitriptyline (Elavil) for 2 weeks. He tells the nurse he doesn't think this medicine is working, as he is still depressed. What is the best response by the nurse?

Correct Answer: A

Rationale: Amitriptyline, a tricyclic antidepressant, typically requires 2 to 6 weeks to achieve full therapeutic effect, as it gradually increases neurotransmitter levels (e.g., serotonin, norepinephrine) in the brain to alleviate depression. After only 2 weeks, the patient's continued symptoms are expected, not indicative of failure, making choice A the best response: it educates the patient on the timeline, fostering adherence. Choice B dismisses the patient's feelings with subjective reassurance, undermining trust. Choice C prematurely suggests switching drugs without evidence, risking unnecessary changes. Choice D exaggerates the timeline to months, which is inaccurate and discouraging. The nurse's role is to provide accurate information and support, reinforcing that delayed onset is normal for this class of medication, thus making choice A the most therapeutic and evidence-based response.

Correct Answer: C

Rationale: Potassium supplements are contraindicated in patients with renal disease because impaired kidney function can lead to the inability to adequately excrete potassium. This can result in potentially dangerous hyperkalemia (high potassium levels) in the bloodstream, which can cause serious cardiac dysrhythmias. Therefore, patients with renal disease should be cautious when taking potassium supplements or may need to avoid them altogether to prevent complications.

Correct Answer: C

Rationale: Phenytoin (Dilantin) belongs to the therapeutic class of anticonvulsants. Anticonvulsants are medications primarily used to treat and prevent seizures and are commonly prescribed for patients with epilepsy. Phenytoin works by stabilizing the electrical activity in the brain to prevent abnormal brain activity that leads to seizures. It is not classified as a mood stabilizer or bronchodilator; its main purpose is to control epileptic seizures.

Correct Answer: C

Rationale: Anatomy, physiology, and microbiology underpin pharmacology, enabling nurses to grasp drug actions and patient responses, enhancing care through informed medication use. As an outgrowth oversimplifies their integration. Curriculum mandates explain requirements, not value. Understanding is key, but applying it to care-like knowing antibiotic targets or drug effects on organs-grounds pharmacology in practice, making it the best rationale.

Correct Answer: A

Rationale: MAOIs (e.g., phenelzine) block tyramine breakdown, risking hypertensive crisis with foods like cheese, per pharmacology. SSRIs, beta blockers, and benzos lack this interaction-tyramine isn't their concern. MAOIs' dietary restriction is critical, a unique safety point.

Correct Answer: D

Rationale: Weight loss, tachycardia, and goitre suggest hyperthyroidism (e.g., Graves'). Verapamil controls rate but not thyroid function. Radioactive iodine (131I) treats long-term, not immediately. Carbamazepine is for seizures, L-thyroxine worsens hyperthyroidism. Atenolol, a beta-blocker, immediately reduces tachycardia and symptoms by blocking adrenergic effects, suitable for acute management while awaiting antithyroid drugs (e.g., propylthiouracil). Its symptomatic relief is critical in hyperthyroid crises.

Correct Answer: C

Rationale: Lithium is a medication commonly used to treat bipolar disorder. One of the major side effects of lithium therapy is the risk of developing seizures, especially when the blood level of lithium becomes too high (lithium toxicity). Therefore, it is crucial to monitor patients on lithium therapy for signs of seizures, such as convulsions, loss of consciousness, or twitching. Monitoring lithium levels regularly and adjusting the dosage as needed can help reduce the risk of seizures in patients taking this medication.

Correct Answer: A

Rationale: Amitriptyline, a tricyclic antidepressant, typically requires 2 to 6 weeks to achieve full therapeutic effect, as it gradually increases neurotransmitter levels (e.g., serotonin, norepinephrine) in the brain to alleviate depression. After only 2 weeks, the patient's continued symptoms are expected, not indicative of failure, making choice A the best response: it educates the patient on the timeline, fostering adherence. Choice B dismisses the patient's feelings with subjective reassurance, undermining trust. Choice C prematurely suggests switching drugs without evidence, risking unnecessary changes. Choice D exaggerates the timeline to months, which is inaccurate and discouraging. The nurse's role is to provide accurate information and support, reinforcing that delayed onset is normal for this class of medication, thus making choice A the most therapeutic and evidence-based response.

Correct Answer: D

Rationale: Amitriptyline, a tricyclic antidepressant, has anticholinergic effects that slow gastric motility, reducing the rate of gastric emptying.