When the nurse is reviewing a list of medications taken by an 88-year-old patient, the patient says, 'I get dizzy when I stand up.' She also states that she has nearly fainted 'a time or two' in the afternoons. Her systolic blood pressure drops 15 points when she stands up. Which type of medication may be responsible for these effects?

Correct Answer: D

Rationale: Orthostatic hypotension, characterized by dizziness and a drop in blood pressure upon standing, is a common side effect of antihypertensive medications. These medications lower blood pressure, which can lead to reduced cerebral perfusion and dizziness when the patient changes positions. NSAIDs, cardiac glycosides, and anticoagulants are less likely to cause orthostatic hypotension. Therefore, the nurse should consider antihypertensive medications as the most likely cause of the patient's symptoms and assess the need for dosage adjustments or alternative treatments.

Correct Answer: B

Rationale: Carbidopa enhances levodopa in Parkinson's. It inhibits peripheral (not cerebral) dopa decarboxylase, reducing levodopa breakdown outside the brain, allowing more to cross the blood-brain barrier. This reduces peripheral dopamine, minimizing nausea and hypotension, permitting lower levodopa doses, a true statement. It's compatible with warfarin, doesn't delay bradykinesia improvement (enhances onset), and doesn't abolish on-off effects (related to disease progression). Reduced side effects improve tolerability, a key therapeutic strategy.

Correct Answer: D

Rationale: At high doses, aspirin shifts to zero-order kinetics, not first-order, due to saturated metabolism, so that's false. Aspirin irreversibly inhibits COX, not reversibly, distinguishing it from other NSAIDs, making that false. At low doses (≤2 g/day), aspirin retains uric acid, not reduces it (uricosuric at >4 g/day), so that's incorrect. All NSAIDs, including aspirin and ibuprofen, distribute into synovial fluid with repeated dosing, a true statement, aiding arthritis treatment. Combining ibuprofen and aspirin reduces, not increases, efficacy due to competition. Synovial penetration is key to their anti-inflammatory action in joints.

Correct Answer: C

Rationale: Anatomy, physiology, and microbiology provide foundational knowledge for pharmacology, enabling nurses to understand drug actions, interactions, and patient responses, ultimately enhancing patient care through informed medication administration. Pharmacology as an outgrowth oversimplifies its integration with these sciences. Curriculum mandates explain requirements but not their value. Understanding these subjects is essential, yet the broader goal is applying this to care, not just comprehension. Linking them to patient outcomes-like knowing how antibiotics target bacteria (microbiology) or how drugs affect organs (anatomy/physiology)-grounds pharmacology in practical, holistic nursing practice, making it the strongest rationale.

Correct Answer: C

Rationale: Lipid-soluble drugs distribute widely, crossing membranes like the blood-brain barrier easily, unlike water-soluble ones. The barrier blocks some, not all, drugs. High blood flow aids delivery, not hinders. Protein complexes limit free drug, not enable crossing. Lipid solubility enhances distribution, a pharmacokinetic truth.