When monitoring a patient who is taking hydrochlorothiazide (HydroDIURIL), the nurse notes that which drug is most likely to cause a severe interaction with the diuretic?

Correct Answer: A

Rationale: Hydrochlorothiazide (HydroDIURIL) is a diuretic that can cause electrolyte imbalances, particularly hypokalemia (low potassium levels). Digitalis (digoxin) is a medication commonly used to treat heart conditions, and its therapeutic effect is dependent on adequate potassium levels. If a patient taking hydrochlorothiazide becomes hypokalemic and then takes digitalis, it can lead to an increased risk of digitalis toxicity. This severe interaction highlights the importance of monitoring potassium levels and potential drug interactions when patients are taking hydrochlorothiazide. Potassium supplements would help counteract the potassium loss caused by hydrochlorothiazide and minimize the risk of interactions with digitalis.

Correct Answer: B

Rationale: Individual variation-metabolism, weight, genetics-dictates dose differences, a pharmacokinetic truth explaining her higher amount. Female metabolism isn't universally higher. Hormones affect response, but not broadly dose. Body fat impacts distribution, not directly dose here. Uniqueness covers all factors, reassuring and accurate.

Correct Answer: A

Rationale: Benzodiazepines (e.g., lorazepam) rapidly calm via GABA, making them highly effective for acute anxiety and insomnia, per clinical use. They carry dependence risk-not low. Insurance or cost varies, not unique. Effectiveness drives preference, despite risks, for quick relief.

Correct Answer: D

Rationale: Sildenafil (Viagra), a phosphodiesterase-5 inhibitor, treats erectile dysfunction (ED) by enhancing penile blood flow, a first-line therapy. Leuprolide suppresses testosterone for prostate cancer, worsening ED. Finasteride and tamsulosin, for BPH, don't target ED and may cause it. Sildenafil's vascular action offers rapid efficacy, making it the go-to choice.

Correct Answer: A

Rationale: Superinfections are secondary infections that occur as a result of disrupting the normal balance of microorganisms in the body, often due to prolonged or broad-spectrum antibiotic use. They can involve the emergence of resistant strains or the overgrowth of opportunistic pathogens. Therefore, superinfections are more likely to occur with prolonged antibiotic use or broad-spectrum antibiotics that disrupt the normal flora of the body. It is less common for superinfections to occur with narrow spectrum antibiotics, as they target a more limited range of bacteria and are less likely to disrupt the overall microbial balance in the body.

Correct Answer: C

Rationale: Oxymetazoline treats nasal congestion in allergic rhinitis by acting as an α-adrenergic agonist. Option , increased nasal blood flow, is incorrect-vasoconstriction reduces flow. Option , increased arterial pressure, doesn't directly relieve congestion. Option , receptor stimulation on nasal vasculature, is correct-oxymetazoline stimulates α-receptors, causing vasoconstriction, shrinking swollen mucosa, and improving airflow. Option , transmembrane conductance change, is unrelated to its action. Option (E), understimulation, contradicts its agonist role. This vasoconstrictive effect rapidly alleviates congestion, explaining the symptom improvement. Unlike antihistamines or steroids, oxymetazoline targets vascular tone, not inflammation or histamine, making it ideal for quick relief in rhinitis. Prolonged use risks rebound congestion, but the question focuses on initial efficacy, where receptor-mediated vasoconstriction is key.

Correct Answer: B

Rationale: Sodium bisulfite is commonly added to local anesthetic solutions as a vasoconstrictor. Vasoconstrictors work by constricting blood vessels at the site of injection. This helps to reduce blood flow to the area, which in turn decreases bleeding, prolongs the anesthetic effect, and reduces the risk of systemic toxicity by slowing the absorption of the anesthetic into the bloodstream. Sodium bisulfite specifically acts as a vasoconstrictor in local anesthetics to enhance the overall effectiveness of the numbing agent.

Correct Answer: D

Rationale: The correct action for the nurse to take in this situation is to prepare an epinephrine injection in case of an anaphylactic reaction. The patient's presentation of generalized itching could be a sign of an allergic reaction to morphine sulfate. It is important to be prepared for an anaphylactic reaction, which could potentially be life-threatening. Having epinephrine readily available allows for quick administration if needed to treat the allergic reaction. Reassuring the patient is also appropriate, but the priority in this situation is to be prepared for a possible serious allergic reaction. Administering naloxone to reverse opioid overdose is not indicated based on the patient's current vital signs and symptoms. Having resuscitation equipment available at the bedside is always a good practice, but preparing for an anaphylactic reaction takes precedence in this scenario.

Correct Answer: A

Rationale: Patients with peptic ulcers should stop taking NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) because NSAIDs can worsen the condition and increase the risk of gastrointestinal bleeding and ulcer perforation. NSAIDs inhibit prostaglandin synthesis, which normally helps protect the stomach lining. Therefore, patients with peptic ulcers should avoid NSAIDs and consult their healthcare provider for alternative pain management options.