What action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?

Correct Answer: D

Rationale: The correct answer is D because removing the patch at bedtime and applying a new one in the morning helps to provide a nitrate-free period which prevents the development of tolerance to nitroglycerin. By allowing a nitrate-free interval, the body is less likely to become desensitized to the effects of nitroglycerin, thus maintaining its effectiveness. A: Omitting a dose once a week does not provide a consistent nitrate-free period and may not be effective in reducing tolerance. B: Leaving the patch on for 2 days at a time may lead to continuous exposure and potential tolerance development. C: Cutting the patch in half is not a recommended method as it alters the dose delivery and may lead to inconsistent effects.

Correct Answer: C

Rationale: The correct answer is C: hypertension. Epoetin alfa stimulates red blood cell production, which can lead to increased blood viscosity and subsequently hypertension. This adverse effect is well-documented and requires close monitoring during therapy. Choices A, B, and D are incorrect as anxiety, drowsiness, and constipation are not commonly associated with epoetin alfa therapy. It is important for the nurse to educate the patient on the potential adverse effects of hypertension and the importance of monitoring blood pressure regularly during treatment.

Correct Answer: B

Rationale: The correct answer is B because an agonist interacts with the receptor and initiates changes in cell function. Agonists bind to the receptor and activate it, leading to a cellular response. Choice A is incorrect because agonists do produce an effect. Choice C is too general and does not specifically define the role of an agonist. Choice D describes the mechanism of a potentiator, not an agonist. In summary, an agonist directly interacts with the receptor to elicit a cellular response, making choice B the correct answer.

Correct Answer: C

Rationale: The correct answer is C: Procaine. Patients with liver disease have impaired metabolism and clearance of certain drugs. Procaine is the anesthetic agent of choice in patients with liver disease because it is metabolized in plasma rather than the liver, reducing the risk of toxicity. Lidocaine (A) and Bupivacaine (B) are primarily metabolized by the liver and can accumulate in patients with liver disease, leading to toxicity. Etidocaine (D) is also metabolized by the liver and should be avoided in patients with liver dysfunction. Therefore, Procaine is the safest choice in this scenario.

Correct Answer: B

Rationale: The correct answer is B: Bronchodilation. Isofluorophate is an organophosphate compound that acts as a cholinesterase inhibitor, leading to increased acetylcholine levels. Lacrimation, muscle twitching, and salivation are all effects of increased acetylcholine activity due to cholinesterase inhibition. However, bronchodilation is not typically associated with increased acetylcholine levels. Therefore, the correct answer is B. Choices A, C, and D are incorrect because they are known effects of increased acetylcholine activity.