The patient is prescribed an ACE inhibitor. What primary mechanism of ACE inhibitors will the nurse understand as the therapeutic action?

Correct Answer: C

Rationale: ACE inhibitors work by inhibiting the enzyme angiotensin-converting enzyme (ACE) in the renin-angiotensin-aldosterone system (RAAS). By inhibiting ACE, the conversion of angiotensin I to angiotensin II is blocked. Angiotensin II is a potent vasoconstrictor and also stimulates the release of aldosterone from the adrenal glands. Aldosterone is a hormone that acts on the kidneys to increase reabsorption of sodium and water, leading to increased blood volume and pressure. By inhibiting aldosterone secretion, ACE inhibitors reduce blood volume and lower blood pressure, making them effective in treating hypertension and heart failure.

Correct Answer: D

Rationale: Kallidin is a peptide, specifically a kinin, and is not classified as an eicosanoid. Eicosanoids are a group of lipid mediators derived from arachidonic acid or other fatty acids, including prostaglandins, prostacyclin, thromboxane, and leukotrienes. Although kallidin also plays a role in inflammation and vasodilation like some eicosanoids, it is not part of the eicosanoid family.

Correct Answer: C

Rationale: Propranolol is the drug that undergoes extensive first-pass hepatic metabolism. First-pass metabolism refers to the metabolism of a drug by the liver before it enters the systemic circulation. In the case of propranolol, a significant portion of the drug is metabolized by the liver before reaching the systemic circulation, leading to reduced bioavailability. This is why propranolol is often given in higher doses to achieve the desired therapeutic effect. Heparin, insulin, nitroglycerine, and warfarin do not undergo significant first-pass metabolism by the liver.

Correct Answer: B

Rationale: Acetaminophen overdose is hepatotoxic and can cause severe liver damage, leading to liver failure if not treated promptly. The liver metabolizes acetaminophen into a toxic metabolite, N-acetyl-p-benzoquinone imine (NAPQI), which depletes glutathione stores and causes cellular damage. Early administration of N-acetylcysteine (NAC) is critical to prevent irreversible liver damage. While kidney injury can occur, it is less common than liver damage.

Correct Answer: A

Rationale: When a patient is on Warfarin therapy, the two primary tests that need to be monitored are the Prothrombin Time (PT) and the International Normalized Ratio (INR). Warfarin works by inhibiting the activity of Vitamin K-dependent clotting factors, and both PT and INR are measures of the extrinsic pathway of coagulation, which is primarily affected by Warfarin. PT measures the time it takes for blood to clot, while INR is a standardized calculation based on the PT value to monitor the effectiveness and safety of Warfarin therapy. Monitoring these tests helps ensure that the patient's blood is not too thick (increased risk of clotting) or too thin (increased risk of bleeding) while on Warfarin.

Correct Answer: C

Rationale: A solution is a liquid preparation that contains one or more chemical substances dissolved in a suitable solvent. The solute (chemical substance) is evenly dispersed and mixed with the solvent, resulting in a homogenous mixture. Solutions are commonly used in medicine for oral administration, injections, topical treatments, and various other applications due to their ability to provide accurate dosing and rapid absorption into the body. decoction is a liquid derived from boiling plant material, fluid extract is a concentrated liquid extract of a substance, spirits are alcoholic solutions, and syrup is a viscous solution containing sugar.

Correct Answer: A

Rationale: Iron supplements are known to commonly cause gastrointestinal side effects, such as constipation, upset stomach, and nausea. Constipation is a common side effect of iron supplements due to the way iron can harden the stool and slow down bowel movements. Upset stomach and nausea can occur because iron supplements can irritate the stomach lining, leading to discomfort and feelings of queasiness. It is important for individuals taking iron supplements to be aware of these potential side effects and to speak with their healthcare provider if they are experiencing severe or persistent symptoms.

Correct Answer: B

Rationale: - Antacids can reduce the absorption of tetracycline when taken together. It is recommended to separate the administration of tetracycline and antacids by at least 2-3 hours to minimize this interaction.

Correct Answer: B

Rationale: Combination chemotherapy is used to target cancer cells at different stages of the cell cycle and through multiple mechanisms of action. Alkylating agents, antimetabolites, and antitumor antibiotics each work differently: alkylating agents damage DNA, antimetabolites interfere with DNA synthesis, and antitumor antibiotics inhibit RNA synthesis. By combining these drugs, the treatment can kill more cancer cells and reduce the likelihood of resistance. This approach maximizes tumor cell killing while minimizing the risk of relapse. Dose-limiting toxicities still exist, but the combination strategy allows for lower doses of each drug, reducing individual side effects.