Which one of the following is an established clinical use of morphine?

Correct Answer: C

Rationale: Morphine, a potent opioid analgesic, is primarily used to manage moderate to severe pain, but its established clinical applications extend beyond analgesia. One well-documented use is in treating pulmonary congestion, particularly in acute pulmonary edema associated with heart failure. Morphine reduces preload by causing vasodilation, alleviating dyspnea and anxiety in these patients, though the exact mechanism is multifaceted and includes central effects on respiration. Managing generalized anxiety disorders is not a standard use, as anxiolytics like benzodiazepines are preferred. While morphine can relieve pain, its use in biliary colic is contraindicated because it causes sphincter of Oddi constriction, potentially worsening the condition. It is not a treatment for ACE inhibitor-induced cough, which is better managed with antitussives or drug discontinuation. Suppression of ethanol withdrawal is also not an established role, as benzodiazepines are the standard. Thus, pulmonary congestion stands out as a recognized therapeutic use.

Correct Answer: C

Rationale: Insomnia is not a common side effect of Alprazolam. Alprazolam is a benzodiazepine medication commonly used to treat anxiety and panic disorders. Common side effects of Alprazolam include dizziness, drowsiness, and lethargy. However, it is not typically associated with causing insomnia as a side effect. If a person experiences unusual symptoms while taking Alprazolam, they should consult their healthcare provider for guidance.

Correct Answer: B

Rationale: Fluticasone, a corticosteroid, is contraindicated with active infections (e.g., viral colds) due to immunosuppression risks . 'My kids have a head cold' suggests exposure, prompting nurse-prescriber collaboration to assess infection status. Licorice , psoriasis , and fruit don't contraindicate use. Choice B prioritizes safety, avoiding exacerbation of undetected infection.

Correct Answer: A

Rationale: Increasing the temperature does not result in local analgesia. In fact, higher temperatures can often lead to increased pain sensitivity. Local analgesia is achieved through methods such as chemically or physically damaging nerve trunks, stimulating large fiber nerve activity, or rendering tissue anemic. These procedures work by interrupting the transmission of pain signals to the brain or by reducing the sensitivity of local nerve endings to pain stimuli.

Correct Answer: D

Rationale: Erectile dysfunction drugs, such as Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil), are contraindicated with nitroglycerin. Both nitroglycerin and erectile dysfunction drugs can cause a sudden decrease in blood pressure when taken together, leading to a serious drop in blood pressure. This could result in dizziness, lightheadedness, fainting, and even potentially life-threatening complications like a heart attack or stroke. Therefore, it is crucial to avoid the combination of nitroglycerin with erectile dysfunction medications to prevent these adverse effects.