What is an expected outcome for Lithium

Correct Answer: D

Rationale: Lithium is commonly used to treat bipolar disorder, where it is effective in reducing the frequency and severity of acute manic episodes. By stabilizing mood, lithium helps in preventing or decreasing the occurrence of manic episodes, which are characterized by elevated, irritable moods, increased energy, and impulsivity. However, it is important to note that lithium does not typically have direct effects on reducing the risk of myocardial infarction, GI ulcers, or respiratory distress.

Correct Answer: A

Rationale: Lyme disease (bulls-eye rash) in a 6-year-old is treated with doxycycline, but tooth discoloration in children under 8-contraindicates it. Tetracyclines bind calcium, staining developing teeth. Anemia , nephrotoxicity , and ototoxicity are rare. Myalgias (E) aren't relevant. Given his age, amoxicillin is preferred to avoid this permanent cosmetic effect, despite doxycycline's efficacy against Borrelia burgdorferi.

Correct Answer: C

Rationale: Lorazepam is a benzodiazepine commonly used as a preanesthetic medication due to its anxiolytic and sedative properties. In patients undergoing liver transplantation, where hepatic function is compromised, drugs that rely on liver metabolism could accumulate and cause excessive central nervous system depression. Lorazepam's key advantage lies in its pharmacokinetic profile: it undergoes glucuronidation, a conjugation process that occurs outside the liver, primarily in the kidneys. This extrahepatic metabolism ensures that its clearance is less affected by liver dysfunction, reducing the risk of prolonged or excessive sedation. Unlike other benzodiazepines that depend heavily on hepatic cytochrome P450 enzymes, lorazepam's metabolism is more predictable in such patients, making it a safer choice. Excretion in unchanged form or secretion into the GI tract does not apply, and while it is anxiolytic, it does have CNS depressant effects, ruling out other options. Naloxone reverses opioids, not benzodiazepines.

Correct Answer: B

Rationale: Levodopa is absorbed via an active transport mechanism using amino acid transporters, allowing it to cross the blood-brain barrier for its therapeutic effect.

Correct Answer: C

Rationale: The fundamental action of drugs that can be used as a substitute for what is lacking in the body falls under the category of Replacement. In medical terms, replacement therapy is a type of treatment that involves replacing a hormone or other important substance that is deficient or lacking in the body. For example, individuals with hypothyroidism are often prescribed levothyroxine as a replacement therapy to make up for the thyroid hormone deficiency in their body. Similarly, insulin is used to replace the deficient insulin in individuals with diabetes. Therefore, when drugs are administered to compensate for a deficiency or lack of a specific substance in the body, they are categorized under the fundamental action of Replacement.

Correct Answer: D

Rationale: Antilipemic therapy is used to lower cholesterol levels in the blood. This type of therapy often places a strain on the liver as it metabolizes and processes the cholesterol-lowering medications. Therefore, patients receiving antilipemic therapy are at an increased risk of developing liver dysfunction. The nurse should monitor the patient closely for signs and symptoms of liver dysfunction, such as jaundice, abdominal pain, nausea, vomiting, and changes in liver function tests. Early detection and intervention can help prevent serious complications associated with liver dysfunction.

Correct Answer: A

Rationale: Amiodarone, labetalol, and carvedilol are not indicated for pediatric use and do not have established pediatric dosages. Phentolamine and prazosin have established pediatric dosages and would not need to be questioned. The nurse should always verify the appropriateness of medications for pediatric patients, as their pharmacokinetics and pharmacodynamics differ from adults.

Correct Answer: D

Rationale: Central venous access devices (CVADs) can be of value in a patient receiving chemotherapy who has stomatitis and severe diarrhea by allowing concentrated hyperalimentation fluid to be administered through the CVAD. Stomatitis and severe diarrhea can significantly affect oral intake and absorption of nutrients, leading to malnutrition and dehydration. By administering concentrated hyperalimentation fluid through a CVAD, the patient can receive the necessary nutrition and hydration directly into the bloodstream, bypassing the gastrointestinal tract. This can help maintain the patient's nutritional status and manage dehydration effectively during chemotherapy treatment.

Correct Answer: B

Rationale: Ethanol competes with methanol metabolism, not enhances it, increasing toxicity, so that's false. Grapefruit juice inhibits CYP3A4, reducing cyclosporin metabolism, raising levels, a true statement critical for transplant patients. Phenytoin induces, not inhibits, theophylline metabolism, lowering levels. Rifampicin induces, not inhibits, oral contraceptive metabolism, reducing efficacy. Griseofulvin induces warfarin metabolism, not inhibits. Grapefruit juice's effect is a classic drug-food interaction, necessitating dose adjustments or avoidance.