What medication, if ordered for an 8-year-old patient, should the nurse question? (Select all that apply.)

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: B

Rationale: Lovastatin's myopathy (muscle pain) suggests a CYP3A4 interaction. Grapefruit juice inhibits CYP3A4, increasing lovastatin levels, causing toxicity. Barbiturates , Griseofulvin , and Phenytoin induce CYP3A4, reducing levels. St. John's wort (E) also induces. Grapefruit juice fits the timeline and mechanism, explaining the adverse effect.

Correct Answer: D

Rationale: The clinical features of inflammation are known by the Latin terms "rubor" (redness), "calor" (heat), "tumor" (swelling), and "dolor" (pain). These are classic signs of inflammation that occur in response to tissue injury or infection. "Bacterial invasion" is not a clinical feature, but rather a cause of inflammation. Bacterial invasion can lead to the activation of the inflammatory response, resulting in the characteristic signs of inflammation such as redness, heat, swelling, and pain.

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: B

Rationale: A. Stroke is not typically associated with an adverse reaction to Montelukast. The most common adverse reactions include neuropsychiatric events such as mood changes, suicidal thoughts/behaviors, and allergic reactions affecting the skin and mucous membranes.

Correct Answer: D

Rationale: Clopidogrel is a medication that belongs to the antiplatelet class of drugs. It works by preventing platelets in the blood from sticking together and forming clots, thereby reducing the risk of thromboembolic events, such as heart attacks and strokes. Warfarin (Choice A) is an anticoagulant medication that also helps prevent blood clots, but it works by inhibiting the clotting factors in the blood rather than the platelets. Amlodipine (Choice B) and Nitroglycerine (Choice C) are medications used to treat high blood pressure and angina, respectively, and do not have a direct effect on preventing thromboembolic events.

Correct Answer: C

Rationale: The patient is experiencing gastrointestinal upset from taking aspirin. Enteric-coated aspirin would be a suitable alternative in this case because the special coating on the aspirin helps protect the stomach lining and reduces the risk of gastrointestinal irritation. Switching to an enteric-coated aspirin can still provide the antiplatelet benefits needed for secondary prevention of myocardial infarction while minimizing the gastrointestinal side effects. It is important to address the patient's symptoms while ensuring that they continue to receive appropriate treatment for their medical condition.

Correct Answer: A

Rationale: When a client receives total parenteral nutrition (TPN), monitoring blood glucose levels is critical due to the high glucose content in TPN solutions, which can lead to hyperglycemia. This condition arises because TPN delivers concentrated nutrients directly into the bloodstream, bypassing the digestive system, and the body may struggle to regulate sugar levels effectively without proper insulin response. Potassium levels, while important in overall electrolyte balance, are less immediately impacted by TPN compared to glucose, as potassium imbalances typically develop over time rather than acutely from TPN initiation. Mental status assessments are valuable for neurological conditions but lack direct relevance to TPN's metabolic effects. Similarly, blood pressure monitoring is essential for cardiovascular health but isn't the primary concern with TPN, as it doesn't directly influence hypertension or hypotension in the same way glucose dysregulation does. The focus on glucose stems from its rapid impact on the client's metabolic state, making it the priority assessment to prevent complications like hyperglycemia, which can escalate to severe outcomes if unaddressed. Regular monitoring ensures timely intervention, aligning with TPN's nutritional goals.

Correct Answer: D

Rationale: Serotonin reuptake blockade increases synaptic levels. Buspirone, a 5-HT1A agonist, treats anxiety without reuptake effects. Pizotifen, a serotonin antagonist, prevents migraines. Granisetron, a 5-HT3 antagonist, controls nausea. Paroxetine, an SSRI, potently inhibits serotonin reuptake, elevating mood in depression. Sumatriptan activates 5-HT1 receptors. Paroxetine's mechanism is central to its antidepressant efficacy, distinguishing it from receptor modulators.