The thiazolidinediones are useful in treating type II diabetes because they have which of the following effects?

Correct Answer: D

Rationale: The correct answer is D) Improve insulin sensitivity. Thiazolidinediones, such as pioglitazone and rosiglitazone, are a class of medications used to treat type II diabetes by improving insulin sensitivity. They work by activating peroxisome proliferator-activated receptor gamma (PPAR-gamma) in adipose tissue, skeletal muscle, and the liver. This activation leads to increased insulin sensitivity in these tissues, allowing for better utilization of glucose and improved glycemic control. Option A) Decrease the degradation of insulin is incorrect because thiazolidinediones do not affect insulin degradation directly. Option B) Increase insulin release is incorrect because thiazolidinediones do not stimulate the pancreas to release more insulin. Option C) Decrease glucose uptake in muscle cells is incorrect because thiazolidinediones actually increase glucose uptake in muscle cells by improving insulin sensitivity. In an educational context, understanding the mechanism of action of thiazolidinediones is crucial for nursing students preparing for the NCLEX. Knowledge of how these drugs work will help students make informed decisions when caring for patients with type II diabetes who are on thiazolidinedione therapy. Understanding the specific effects of thiazolidinediones on insulin sensitivity can also help students differentiate these medications from other classes used in diabetes management.

Correct Answer: D

Rationale: Tamoxifen (choice D), a SERM, is standard for ER/PR-positive breast cancer post-lumpectomy, blocking estrogen-driven tumor growth. Flutamide (choice A) targets androgen receptors, Leuprolide (choice B) suppresses gonadal hormones in prostate cancer, Mifepristone (choice C) blocks progesterone elsewhere. Tamoxifen's receptor-specific action is key for adjuvant therapy, reducing recurrence risk in hormone-sensitive cancers.

Correct Answer: A

Rationale: The correct answer is A) Metabolites are important to the action of these drugs. This statement is true because many antipsychotic drugs are prodrugs, meaning they are metabolized in the body to active forms that exert their therapeutic effects. For example, clozapine is metabolized to its active form, norclozapine, which contributes significantly to its antipsychotic actions. Option B) Haloperidol has higher systemic availability than thioridazine is incorrect because thioridazine actually has higher systemic availability due to its efficient absorption and bioavailability. Option C) Elimination half-lives of these drugs range between 3-6 hours is incorrect as the elimination half-lives of antipsychotic drugs vary widely, with some having much longer half-lives, such as fluphenazine which can range from 16 to 50 hours. Option D) This group of drugs generally has short clinical duration of action is incorrect as some antipsychotics like depot injections (e.g., fluphenazine decanoate) can have prolonged durations of action lasting weeks to months. Educationally, understanding the pharmacokinetics of antipsychotic drugs is crucial for nurses and healthcare professionals to safely administer and monitor these medications in patients with psychiatric disorders. Knowing the differences in metabolism, availability, half-lives, and duration of action can help optimize treatment outcomes and minimize adverse effects.

Correct Answer: D

Rationale: Phenytoin is a commonly used antiepileptic drug that works by stabilizing neuronal membranes. The correct answer, D) Steady-state mean plasma concentrations vary disproportionately with dose, is accurate because phenytoin exhibits non-linear pharmacokinetics. This means that as the dose increases, the plasma concentration does not increase proportionally, leading to variations in steady-state levels. Option A) Is 20-30% bound to albumin is incorrect because phenytoin is highly protein-bound (usually around 90%), not 20-30%. Option B) Is the drug of choice for absence seizures is incorrect as ethosuximide is typically the preferred choice for treating absence seizures. Option C) Undergoes flow-limited elimination is incorrect because phenytoin undergoes saturable metabolism in the liver, leading to dose-dependent kinetics rather than flow-limited elimination. Understanding the pharmacokinetic properties of phenytoin is crucial for healthcare professionals to ensure appropriate dosing and monitoring. Non-linear kinetics can result in unexpected changes in plasma concentrations with dose adjustments, emphasizing the need for close monitoring and individualized dosing regimens to optimize therapeutic outcomes while minimizing adverse effects.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Suxamethonium. Suxamethonium is a depolarizing neuromuscular blocking agent used during surgical procedures to induce muscle relaxation. Post-operatively, muscle pain can occur due to the fasciculations caused by the depolarizing action of suxamethonium on skeletal muscles. This muscle pain is a common side effect of suxamethonium administration. Option B) Propofol is a general anesthetic that does not directly cause muscle pain. Option C) Isoflurane is an inhaled anesthetic that also does not typically cause muscle pain. Option D) Atracurium is a non-depolarizing neuromuscular blocking agent that works differently from suxamethonium and is less likely to cause muscle pain post-operatively. Educationally, understanding the mechanisms of action and side effects of different medications used during surgical procedures is crucial for nurses and healthcare providers to provide safe and effective post-operative care. Recognizing the potential side effects of medications allows for prompt identification and management of complications, improving patient outcomes.