While caring for a patient with cirrhosis or hepatitis, the nurse knows that abnormalities in which phase of pharmacokinetics may occur?

Correct Answer: C

Rationale: Cirrhosis and hepatitis impair liver function, which directly affects the metabolism of drugs. The liver is responsible for metabolizing many medications through processes such as oxidation, reduction, and hydrolysis. When liver function is compromised, drug metabolism may be slowed, leading to increased drug levels and a higher risk of toxicity. While absorption, distribution, and excretion can also be affected by liver disease, metabolism is the most significantly impacted phase. Therefore, nurses must carefully monitor drug dosages and consider alternative medications for patients with liver dysfunction.

Correct Answer: C

Rationale: Acute schizophrenia requires antipsychotics for positive symptoms (e.g., hallucinations). IV haloperidol is for acute agitation, not first-line outpatient treatment. IM flupentixol, a long-acting typical antipsychotic, suits maintenance, not initial therapy. Oral olanzapine, an atypical antipsychotic, is first-line, balancing efficacy (D2/5-HT2 blockade) and lower extrapyramidal risk, suitable for a young patient. Procyclidine treats parkinsonism, not schizophrenia. Fluoxetine is for depression. Olanzapine's oral route and profile make it ideal for initial management, promoting adherence and tolerability.

Correct Answer: B

Rationale: Penicillins cross the blood-brain barrier mainly when meninges are inflamed (e.g., meningitis), a true statement due to increased permeability. They do require dose adjustment in renal failure, as they're renally excreted, making the lack of adjustment false and the exception. They inhibit bacterial cell wall synthesis by blocking peptidoglycan cross-linkage, a true mechanism. Piperacillin is effective against Pseudomonas, especially with tazobactam, which is true. Only 5-10% of those with prior penicillin allergy react again, also true. The renal adjustment need is critical, as accumulation risks toxicity like seizures, guiding safe prescribing in kidney dysfunction.

Correct Answer: C

Rationale: Androgens, primarily testosterone, are secreted by the testes' Leydig cells, stimulated by luteinizing hormone (LH) from the pituitary, making the testes the direct source. Follicle-stimulating hormone (FSH) from the pituitary regulates sperm production, not androgen secretion. Gonadotropin-releasing hormone (GnRH) from the hypothalamus triggers pituitary LH and FSH release, indirectly influencing androgen production, not secreting it. The pituitary releases LH and FSH, not androgens itself. The testes' role as the endocrine organ producing androgens is clear, driven by LH, and is fundamental to male reproductive and secondary sexual characteristics, setting it apart from regulatory hormones in the hypothalamic-pituitary-gonadal axis.

Correct Answer: C

Rationale: A P450 enzyme inducer (e.g., rifampin) speeds metabolism of itself and other drugs, reducing its own effect over time as levels drop faster, requiring dose adjustments. No effect on others is extreme-some drugs' metabolism increases, lowering their effect. Increased effects suggest inhibition, not induction. Self-induction lowers efficacy, a pharmacokinetic principle affecting long-term use.