While monitoring a patient who had surgery under general anesthesia 2 hours ago, the nurse notes a sudden elevation in body temperature. This finding may be an indication of which problem?

Correct Answer: D

Rationale: The sudden elevation in body temperature post-surgery under general anesthesia is indicative of malignant hyperthermia (MH), a rare but life-threatening condition triggered by certain anesthetics. Here's why D is the correct answer: 1. MH is characterized by a rapid increase in body temperature due to uncontrolled muscle metabolism. 2. Common signs include tachycardia, muscle rigidity, and high fever. 3. Prompt recognition and treatment are crucial to prevent serious complications. On the other hand: A: Tachyphylaxis is a rapid decrease in response to a drug with repeated dosing. B: Postoperative infection would typically present with localized signs like redness, swelling, and purulent discharge. C: Malignant hypertension is marked by severely elevated blood pressure, not body temperature.

Correct Answer: C

Rationale: The correct answer is C: acetaminophen (Tylenol). Acetaminophen is the preferred pain reliever for patients on warfarin therapy because it does not interfere with the blood-thinning effects of warfarin. Aspirin, ibuprofen, and opioids can increase the risk of bleeding when taken with warfarin due to their antiplatelet or anti-inflammatory effects. Acetaminophen provides effective pain relief without affecting the anticoagulant properties of warfarin, making it the safest choice for this patient.

Correct Answer: D

Rationale: The correct answer is D because a decrease in symptoms of tuberculosis, improved chest x-rays, and sputum cultures indicate a therapeutic response to antitubercular therapy. This shows that the medication is effectively treating the infection. A: The chronic cough being gone does not necessarily indicate a therapeutic response as other symptoms and tests need to be considered. B: Two consecutive negative PPD results do not directly correlate with the effectiveness of antitubercular therapy as they measure immune response, not treatment response. C: Increased tolerance to medication and fewer reports of adverse effects are positive outcomes but do not directly indicate the effectiveness of the antitubercular therapy.

Correct Answer: A

Rationale: The correct answer is A: Acetylation. In the second phase of biotransformation, conjugation reactions occur where a functional group is added to the drug molecule. Acetylation involves the addition of an acetyl group to the drug molecule, making it more water-soluble and easier to excrete. Reduction (B) typically occurs in the first phase, oxidation (C) can occur in both phases, and hydrolysis (D) usually occurs in the first phase as well. Therefore, acetylation is the most likely process to proceed in the second phase of biotransformation.

Correct Answer: A

Rationale: The correct answer is A because a good local anesthetic agent should not cause local irritation and tissue damage. Local anesthetics work by blocking nerve signals in a specific area, without causing harm to surrounding tissues. Choices B, C, and D are incorrect because systemic toxicity, fast onset, and long duration of action, and vasodilatation are all aspects that can be associated with local anesthetics but are not necessarily indicative of a poor local anesthetic agent.