Which of the following adverse effects is most likely to occur during the first days of lithium therapy?

Correct Answer: C

Rationale: The correct answer is C: Insomnia. During the first days of lithium therapy, individuals are more likely to experience insomnia due to the stimulating effects of lithium on the central nervous system. This can disrupt sleep patterns and cause difficulty falling or staying asleep. Choice A (Constipation) is less likely to occur as lithium is not known to have a significant impact on gastrointestinal motility. Choice B (Weight loss) is also less likely as weight gain is a more common side effect of lithium therapy. Choice D (Hypertension) is not typically seen in the initial days of lithium therapy, as lithium is more commonly associated with long-term kidney-related issues leading to hypertension.

Correct Answer: D

Rationale: The correct answer is D, the lateral hypothalamus. Amphetamines are known to suppress appetite by affecting the lateral hypothalamus, a region of the brain responsible for regulating hunger and feeding behavior. Stimulation of the lateral hypothalamus can lead to reduced food intake. Choices A, B, and C are not directly involved in appetite regulation and do not play a significant role in the anorectic action of amphetamines.

Correct Answer: C

Rationale: The correct answer is C: Guanfacine. Guanfacine is commonly prescribed for children with irritability and self-injurious behavior due to its effectiveness in treating symptoms of ADHD and disruptive behavior disorders. It helps regulate impulse control and reduce aggression. Dextroamphetamine and Methylphenidate (Choices A and B) are stimulant medications primarily used for ADHD but may not directly address irritability and self-injurious behavior. Bupropion (Choice D) is an antidepressant and not typically the first choice for managing irritability and self-injurious behavior in children.

Correct Answer: D

Rationale: The correct answer is D: Fentanyl. Fentanyl is a potent synthetic opioid commonly used for severe pain management. The patient most likely took Fentanyl due to its high potency, fast onset of action, and effectiveness in managing severe pain. Buprenorphine (A) is a partial opioid agonist used for opioid addiction treatment, not typically for severe pain. Morphine (B) is a strong opioid but less potent than Fentanyl and not commonly used for severe pain management. Pentazocine (C) is a mixed opioid agonist-antagonist and not as potent as Fentanyl for severe pain relief.

Correct Answer: D

Rationale: The correct answer is D: Morphine. Morphine is contraindicated in acute myocardial infarction due to its potential to cause hypotension and respiratory depression, which can worsen the patient's condition. Morphine can also increase myocardial oxygen demand, further compromising the patient's heart function. Rationale: - A: Amitriptyline is a tricyclic antidepressant and is not typically contraindicated in acute myocardial infarction. - B: Acetaminophen is a non-opioid analgesic and is generally safe to use in patients with acute myocardial infarction. - C: Haloperidol is an antipsychotic medication and is not typically contraindicated in acute myocardial infarction.