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: D

Rationale: Infliximab, a biologic agent used to treat psoriasis, can suppress the immune system and increase the risk of infections and blood disorders. Monitoring the complete blood count (D) is a priority to detect neutropenia, anemia, or thrombocytopenia. Monitoring weight (A), electrolytes (B), or urine output (C) is not typically associated with infliximab therapy.

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: A

Rationale: Premature infants, especially those born very premature or with health complications, often require blood transfusions due to their underdeveloped organs and medical conditions. Their small size and medical fragility make them the age group that typically uses the most units of blood and blood products. This high demand for blood products is necessary to support their growth, development, and overall health. Conversely, while individuals in other age groups may also require blood transfusions, premature infants have specific and ongoing needs that often result in a greater overall use of blood and blood products in this age group.

Correct Answer: C

Rationale: Lithium is commonly used as a mood stabilizer in the treatment of bipolar disorder. It helps reduce the intensity of manic episodes, thereby stabilizing the patient's mood and preventing extreme mood swings. While lithium is primarily known for its mood-stabilizing effects, it is not used to lower blood glucose, slow the heart, or heal ulcers.

Correct Answer: A

Rationale: Dopamine has a short half-life due to rapid metabolism by monoamine oxidases and catechol-O-methyltransferase, while others have longer half-lives.

Correct Answer: D

Rationale: Procainamide can induce a lupus-like syndrome . Symptoms (malaise, fever, nausea) and malar rash mimic SLE, a known side effect due to drug-induced autoantibodies. Contact dermatitis lacks systemic features. Sun reaction or discoid lupus don't fit the drug link. Collagen disease (E) is vague. This reversible syndrome resolves with discontinuation, distinguishing it from primary lupus.

Correct Answer: B

Rationale: Calcium absorbs best with food-e.g., fat aids uptake, per pharmacokinetics-unlike empty stomach. Insomnia isn't typical-constipation is. Vitamin D matters-enhances absorption. Meal timing optimizes use, per guidance.

Correct Answer: C

Rationale: Redness and pain at the site of the infusion can indicate a potential infiltration or extravasation of the medication, in this case, pentamidine (Pentam) IV. Pentamidine is a medication used to treat Pneumocystis jiroveci (formerly known as Pneumocystis carinii) pneumonia in HIV patients. Infiltration or extravasation of pentamidine can lead to tissue damage, necrosis, and potentially severe complications. Therefore, it is crucial to immediately assess and address any signs of redness and pain at the infusion site to prevent further harm to the patient. This assessment finding should be promptly relayed to the physician for further evaluation and intervention.