When admitting a patient with a suspected diagnosis of chronic alcohol use, the nurse will keep in mind that chronic use of alcohol might result in which condition?

Correct Answer: C

Rationale: The correct answer is C: Korsakoff’s psychosis. Chronic alcohol use can lead to a thiamine deficiency, resulting in Korsakoff’s psychosis characterized by severe memory loss and confabulation. Renal failure (A) is not directly linked to chronic alcohol use. Cerebrovascular accident (B) is more commonly associated with high blood pressure or atherosclerosis. Alzheimer’s disease (D) is a neurodegenerative disorder not directly caused by chronic alcohol use. In summary, Korsakoff’s psychosis is the most likely condition to result from chronic alcohol use due to thiamine deficiency.

Correct Answer: B

Rationale: The correct answer is B: "Take the bronchodilator inhaler first." The rationale for this instruction is that bronchodilators work by relaxing the muscles around the airways, allowing for easier breathing. Taking the bronchodilator first helps open up the airways, making it easier for the corticosteroid to reach deeper into the lungs and be more effective. If the corticosteroid is taken first, it may not reach the lower airways as effectively. Choice A is incorrect because taking the corticosteroid first may not optimize the effectiveness of both medications. Choice C is incorrect as it is important to take these inhalers in a specific order for optimal effect. Choice D is incorrect because the order of inhaler use can impact the effectiveness of the medications.

Correct Answer: A

Rationale: The correct answer is A because the volume of distribution (Vd) is a pharmacokinetic parameter that describes the extent of drug distribution in the body. It is calculated by dividing the total amount of drug in the body by the concentration of the drug in the plasma. Therefore, the concentration of a substance in plasma is essential for determining Vd. Choice B (Concentration of substance in urine) is incorrect because Vd is not calculated based on urine concentration but rather on plasma concentration. Choice C (Therapeutical width of drug action) is unrelated to Vd calculation as it refers to the range of drug concentrations in the body that produce the desired therapeutic effect. Choice D (A daily dose of drug) is also incorrect as Vd is not directly calculated from the daily dose but rather from the concentration of the drug in the plasma.

Correct Answer: D

Rationale: The correct answer is D: Synergism. When drugs are used in combination, synergism can occur where the combined effect is greater than the sum of their individual effects. This can lead to enhanced therapeutic benefits or increased adverse effects. Tolerance (A) is the body's reduced response to a drug over time. Tachyphylaxis (B) is a rapid decrease in response to a drug with repeated administration. Accumulation (C) refers to the build-up of a drug in the body due to insufficient elimination. Synergism (D) is the only choice that specifically addresses the interaction between drugs leading to enhanced effects.

Correct Answer: A

Rationale: Prilocaine is the correct answer as it can cause methemoglobinemia due to its metabolite o-toluidine. This metabolite oxidizes hemoglobin to methemoglobin, leading to reduced oxygen-carrying capacity. Procaine, lidocaine, and ropivacaine do not typically cause methemoglobinemia as they lack the metabolites responsible for this condition. So, prilocaine is the only local anesthetic among the choices that can lead to methemoglobinemia.