The patient has meningitis. The physician initially prescribed a water-soluble drug. Another physician changed the order to a lipid-soluble drug. The patient is confused about this. Which plan best resolves the patient’s concern?

Correct Answer: B

Rationale: The correct answer is B) Teach the patient that lipid-soluble drugs are more effective in treating his illness. In the case of meningitis, lipid-soluble drugs are preferred over water-soluble drugs because they can more easily penetrate the blood-brain barrier to reach the site of infection in the central nervous system. This property makes lipid-soluble drugs more effective in treating meningitis compared to water-soluble drugs. By educating the patient on this, it helps them understand the rationale behind the change in prescription and reinforces the importance of following the healthcare provider's recommendations for optimal treatment outcomes. Option A is incorrect because protein binding is not the primary reason for choosing a lipid-soluble drug in this scenario. Option C is incorrect as lipid-soluble drugs do not necessarily have fewer side effects than water-soluble drugs. Option D is incorrect as the rate of excretion is not the main factor influencing the effectiveness of lipid-soluble drugs in treating meningitis. This educational context is crucial for nursing pharmacology as it helps nurses understand the rationale behind drug selection in specific conditions like meningitis. It emphasizes the importance of patient education in promoting adherence to treatment plans and improving patient outcomes.

Correct Answer: C

Rationale: The correct answer is C) Breast milk. Breast milk is an example of a substance that can be secreted by glandular activity. When medications are excreted through glandular secretion, they can sometimes alter the taste in the mouth, leading to a metallic taste sensation experienced by the patient. Option A) Saliva is not typically involved in the excretion of medications. Saliva is mainly produced by salivary glands to aid in the digestion process by moistening food and breaking down starches. Option B) Sweat is primarily involved in regulating body temperature and excreting waste products like water and electrolytes. Medications are not typically excreted through sweat glands. Option D) Urine is the primary route for excretion of many medications through the kidneys and urinary system. While medications excreted through urine can also lead to taste changes, in this case, the question specifically mentions glandular excretion, not renal excretion. In the context of nursing pharmacology, understanding how medications are excreted from the body is crucial for nurses to anticipate and manage potential side effects and drug interactions. Educating patients about these processes can help them better understand why they may experience certain symptoms after taking medications.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) The patient experiences fewer side effects. Switching from haloperidol, a typical antipsychotic that is a dopamine antagonist, to aripiprazole, an atypical antipsychotic that is a partial dopamine antagonist, is likely to result in fewer side effects for the patient. Haloperidol, being a first-generation antipsychotic, is associated with a higher risk of extrapyramidal side effects such as tardive dyskinesia. On the other hand, aripiprazole, a second-generation antipsychotic, has a lower risk of these side effects due to its unique mechanism of partial dopamine antagonism. The other options are incorrect: A) The patient is more compliant in taking his medication - Compliance with medication is influenced by various factors and changing the medication alone does not guarantee improved compliance. B) The patient experiences greater efficacy - While aripiprazole may be as effective as haloperidol, the question specifically addresses the impact of the change on side effects, not efficacy. C) The patient experiences a greater reduction in symptoms - Both medications can be effective in treating symptoms, but the question focuses on the side effect profile of the medications. In an educational context, understanding the differences between antipsychotic medications in terms of side effect profiles is crucial for nursing pharmacology practice. It is essential for nurses to be able to anticipate and manage potential side effects to ensure patient safety and treatment adherence.

Correct Answer: C

Rationale: In the context of nursing pharmacology, understanding the cellular responses of medications is crucial for safe and effective patient care. In this scenario, the correct answer is C) Osmotic diuretics because they exert their effects through nonspecific mechanisms that involve altering osmotic pressure in the nephron, leading to increased urine output. Option A) Ethyl alcohol primarily acts on the central nervous system and does not have a nonspecific cellular response mechanism like osmotic diuretics. Option B) General anesthetics work by altering neurotransmission in the central nervous system, targeting specific receptors, rather than nonspecific cellular responses. Option D) Calcium channel blockers specifically target calcium channels in cardiac and smooth muscle cells, regulating calcium entry, which is a specific cellular response rather than nonspecific like osmotic diuretics. Educationally, this question highlights the importance of understanding the mechanisms of action of different medication classes in nursing practice. Nurses need to be able to differentiate between medications based on their specific cellular responses to provide safe and individualized care to patients.

Correct Answer: A

Rationale: The correct response is option A) "This is because your blood volume has increased." This answer is correct because during pregnancy, a woman's blood volume expands significantly, leading to dilution of the medication in the bloodstream. This dilution can result in the medication being less effective than before pregnancy. Option B) "Tell me how you have been taking your medication" is incorrect because it does not address the physiological changes occurring during pregnancy that impact medication effectiveness. Option C) "This is because your baby is receiving part of the medication" is incorrect because it implies that the medication is being diverted to the baby, which is not typically the reason for decreased effectiveness during pregnancy. Option D) "Maybe the medication has expired; check the label" is incorrect as it does not consider the specific pharmacokinetic changes that occur in the pregnant body. Educationally, this question highlights the importance of understanding pharmacokinetics in pregnant patients. Nurses need to be aware of how physiological changes during pregnancy can impact medication effectiveness to provide safe and effective care to pregnant individuals. This knowledge is crucial for optimizing treatment outcomes and ensuring the well-being of both the mother and the baby.