Thiopental is used as an anesthetic agent during surgery to repair a small-bowel obstruction in a 78-year-old man. Approximately 1 day after his surgery, toxicology studies still reveal some thiopental present in the bloodstream. What is the most likely explanation for this finding?

Correct Answer: C

Rationale: Thiopental, a barbiturate, persists 24 hours post-surgery. Physiologic metabolism is correct-its lipophilicity causes redistribution to fat, with slow hepatic metabolism, normal in the elderly. Hepatitis or insufficiency lacks evidence. Renal failure doesn't primarily clear it. Trauma (E) is unrelated. This reflects thiopental's pharmacokinetics, not pathology.

Correct Answer: D

Rationale: Food can affect drug absorption (e.g., calcium in dairy binding antihypertensives), so caution with meals enhances efficacy, showing learning. Expired drugs lose potency, risking failure. Storage matters-heat/light degrade drugs. Dairy avoidance is specific, not broad enough. General food caution reflects pharmacokinetic awareness, key for hypertension management.

Correct Answer: C

Rationale: Heroin's appeal comes from its metabolism to morphine , which activates μ-opioid receptors for euphoria. Dopamine , epinephrine , norepinephrine , and serotonin (E) aren't direct products. Morphine's potency drives addiction in this overdose case.

Correct Answer: C

Rationale: The basic metric unit for the measurement of volume is the liter. Although all the other options are also units used for measuring volume, the liter is considered the basic metric unit. It is often used for measuring larger volumes of liquids or gases. The other options are subunits of a liter:

Correct Answer: C

Rationale: MAOIs (e.g., phenelzine) with tyramine-rich foods (chocolate, wine, fava beans) risk hypertensive crisis-per pharmacology-unlike juice/cheese or water/fish. Tyramine avoidance is critical, per diet.

Correct Answer: A

Rationale: Penicillin is inactivated by erythromycin. Penicillin is a beta-lactam antibiotic which acts by inhibiting cell wall synthesis in bacteria. However, erythromycin is a macrolide antibiotic which can inactivate beta-lactam antibiotics like penicillin. When given together, erythromycin can inactivate penicillin, reducing its efficacy and potentially leading to treatment failure. Therefore, it is not appropriate to use both penicillin and erythromycin simultaneously to treat a bacterial infection.

Correct Answer: A

Rationale: Stimulants are drugs that increase the body's activity levels. They work on the central nervous system to enhance alertness, attention, and energy. Examples of stimulants include caffeine, amphetamines, and nicotine. Stimulants can increase heart rate, blood pressure, and metabolism, leading to heightened physical and mental activity.

Correct Answer: A

Rationale: The patient's decreased level of consciousness (somnolence and only responding to noxious stimuli) indicates a potential deterioration in their condition, possibly due to the overdose. Activated charcoal is contraindicated in patients with an altered mental status due to the risk of aspiration. The nurse should immediately consult the nurse practitioner to reassess the patient's condition and determine the appropriate intervention, such as securing the airway or considering alternative treatments.

Correct Answer: B

Rationale: - Tachycardia (increased heart rate) can be an adverse effect of amiodarone. This medication is used to treat irregular heartbeats, so it's important to monitor for any abnormal heart rhythms, including tachycardia.