The wife of a patient who has been diagnosed with depression calls the office and says, “It’s been an entire week since he started that new medicine for his depression, and there’s no change! What’s wrong with him?” What is the nurse’s best response?

Correct Answer: B

Rationale: The correct answer is B. The nurse should explain that it may take up to 4 weeks to notice any therapeutic effects of the new medication for depression. This is because antidepressants typically require time to build up in the patient's system and start producing the desired effects. By advising to wait a little longer, the nurse is providing accurate information and managing the wife's expectations appropriately. Incorrect Choices: A: This answer prematurely suggests changing the medication without allowing sufficient time for the current medication to take effect. C: Increasing the dosage without waiting for the full therapeutic effect to manifest can lead to unnecessary side effects and risks. D: This answer is pessimistic and does not offer constructive guidance or hope for improvement, which is not appropriate in this situation.

Correct Answer: D

Rationale: The correct answer is D: Palpitations. Topically applied adrenergic nasal decongestants can be absorbed systemically, leading to increased sympathetic activity. This can manifest as palpitations due to excessive stimulation of the heart. Heartburn (A) is not a systemic effect of adrenergic nasal decongestants. Bradycardia (B) is unlikely as these drugs typically cause tachycardia. Drowsiness (C) is more commonly associated with antihistamines, not adrenergic decongestants.

Correct Answer: A

Rationale: The correct answer is A: Pretty fast absorption. Sublingual route involves placing the drug under the tongue for direct absorption into the bloodstream through the highly vascular sublingual mucosa. This bypasses the first-pass metabolism in the liver, leading to faster onset of action compared to oral administration. Choice B is incorrect because sublingual administration avoids exposure to gastric secretion. Choice C is incorrect as sublingual administration bypasses liver metabolism. Choice D is incorrect as the variety of doses does not specifically relate to the sublingual route.

Correct Answer: C

Rationale: The correct term for a gradual decrease in responsiveness to a drug over days or weeks is "tolerance." Tolerance occurs due to the body adjusting to the drug's effects, requiring higher doses for the same response. Refractoriness refers to a lack of response, not a reduced response. Cumulative effect refers to increased drug effects with repeated doses. Tachyphylaxis is a rapid decrease in responsiveness, not a gradual one. Therefore, "tolerance" is the best fit for the described scenario.

Correct Answer: B

Rationale: The correct answer is B, Bupivacaine. Bupivacaine is a long-acting local anesthetic with intrinsic vasoconstrictive properties, so using additional vasoconstrictors may not significantly prolong its anesthetic effects. Procaine (A), Lidocaine (C), and Mepivacaine (D) do not have intrinsic vasoconstrictive properties, so adding vasoconstrictors can help prolong their anesthetic effects.