Tricyclic antidepressants

Correct Answer: B

Rationale: Tricyclic antidepressants (TCAs) like imipramine block norepinephrine and serotonin reuptake, but their anticholinergic effects are significant. In glaucoma, particularly angle-closure type, these effects can increase intraocular pressure by dilating pupils and obstructing aqueous humor outflow, risking acute attacks—thus, they're contraindicated. TCAs lower seizure threshold, lacking anticonvulsant activity, and may exacerbate epilepsy. They don't enhance levodopa absorption; rather, they might interact via monoamine pathways, but this isn't a primary effect. Some TCAs (e.g., amitriptyline) have quinidine-like sodium channel blockade, giving antiarrhythmic properties, but this isn't their primary use. The glaucoma concern is critical due to the anticholinergic mechanism, making it a key clinical consideration and the most accurate statement here.

Correct Answer: A

Rationale: Cefotaxime, a third-generation cephalosporin, treats postoperative infections but disrupts gut flora, commonly causing diarrhea due to overgrowth of pathogens like Clostridioides difficile. This adverse effect can range from mild to life-threatening pseudomembranous colitis, making it a priority observation. Headache might occur but is less frequent and specific to cefotaxime. Constipation contrasts with its GI effects, as diarrhea is more typical, while tachycardia could signal anaphylaxis or secondary infection but isn't a primary concern. Monitoring for diarrhea allows early detection of complications, enabling prompt intervention like discontinuing the drug or starting probiotics. This focus aligns with cephalosporins' pharmacological profile, where GI disturbance is a well-documented risk, especially post-surgery when patients are vulnerable. Thus, observing for diarrhea is the nurse's key assessment, ensuring patient safety and effective management of adverse effects, making A the correct choice.

Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: A

Rationale: Enalapril, an ACE inhibitor, causes dry cough via bradykinin buildup, a common effect needing reporting to consider switching (e.g., to an ARB). Fatigue , headache , and nausea are less specific or urgent. Cough aligns with enalapril's pharmacology, critical in hypertension where adherence hinges on tolerability, making A the key side effect to report.

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.