The spouse of a patient who has just been diagnosed with cancer asks, “What do you think about the relationship of stress and the development of cancer? My spouse has been under a huge amount of stress at work, and now they’ve diagnosed cancer.” The answer that best reflects the current thinking about psychoneuroimmunology is:

Correct Answer: A

Rationale: The correct answer is A: "It’s thought that the immune system is negatively affected by high stress." This answer aligns with the current understanding in psychoneuroimmunology that high levels of stress can indeed weaken the immune system, making individuals more susceptible to illnesses like cancer. Chronic stress can lead to dysregulation of the immune system, increasing inflammation and impairing immune responses. Choice B is incorrect because there is substantial evidence supporting the impact of stress on the immune system. Choice C is inaccurate as numerous studies have demonstrated the link between stress and physical health outcomes. Choice D is misleading as various types of stress, not just grief and depression, can contribute to physical illness. Therefore, the correct answer is A as it accurately reflects the relationship between stress and the immune system, which is crucial in understanding the potential impact of stress on the development of cancer.

Correct Answer: D

Rationale: The correct answer is D: Hypotension. Vasodilators relax blood vessels, leading to decreased blood pressure. In older adults, the risk of hypotension is higher due to age-related changes in cardiovascular function. This can result in dizziness, falls, and potential cardiovascular complications. Dry mouth (A), restlessness (B), and constipation (C) are not typically associated with vasodilators and are less concerning compared to the risk of hypotension in elderly patients.

Correct Answer: B

Rationale: The correct answer is B: Diarrhea. Fibric acid derivatives are known to cause gastrointestinal side effects, such as diarrhea. This occurs due to increased bile acid secretion and can lead to loose stools. Constipation (choice A) is not typically associated with fibric acid derivatives. Joint pain (choice C) is not a common side effect of this medication class. Dry mouth (choice D) is also not a typical adverse effect of fibric acid derivatives. Hence, the correct adverse effect is diarrhea.

Correct Answer: C

Rationale: The correct answer is C: Take the iron tablets with meals if gastrointestinal distress occurs. This is because taking iron supplements with food can help reduce gastrointestinal side effects such as stomach upset and nausea. It also enhances iron absorption. A is incorrect because taking iron tablets with milk or antacids can decrease iron absorption. B is incorrect because crushing iron pills can alter their effectiveness and may cause irritation to the stomach lining. D is incorrect because black tarry stools are a common side effect of iron supplements and do not necessarily indicate an emergency situation.

Correct Answer: D

Rationale: The elimination rate constant (Kelim) is a key parameter that quantifies the rate at which a drug is removed from the body. It is directly related to the drug's half-life (t ½). The correct answer is D because the half-life is the time required for the drug concentration to decrease by half in the body, which is a crucial factor in determining the rate of elimination. Rate of absorption (A) refers to the speed at which a drug enters the bloodstream, not its elimination. Maximal concentration in plasma (B) and highest single dose (C) are not directly related to the elimination rate constant, making them incorrect choices.