Which patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?
A 47-year-old female with hypertension
A 52-year-old male with adult-onset diabetes
A 17-year-old female with symptoms of an upper respiratory infection
A 62-year-old male with gout
The Correct Answer is A
A. Phenylephrine is a decongestant that can raise blood pressure, making it contraindicated for individuals with hypertension. Advising a patient with hypertension to avoid phenylephrine is essential to prevent potential cardiovascular complications.
B. While patients with diabetes should be cautious about certain medications, phenylephrine is not specifically contraindicated in this condition.
C. A 17-year-old female with an upper respiratory infection typically does not have contraindications for phenylephrine unless there are underlying conditions not mentioned.
D. Gout does not have a direct contraindication for phenylephrine use, so the patient may not need to avoid it unless other health issues are present.
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Correct Answer is B
Explanation
A. While resting heart rate and blood pressure are important for overall cardiovascular health, they do not specifically assess the effectiveness of atorvastatin in lowering lipid levels.
B. Reviewing laboratory blood work results, particularly lipid panels, is essential to determine the therapeutic effect of atorvastatin, as it directly measures changes in cholesterol levels (such as LDL and total cholesterol).
C. Assessing exercise tolerance and activities of daily living can provide insight into overall health and well-being but does not specifically evaluate the impact of atorvastatin on lipid levels.
D. A focused cardiac assessment is beneficial for understanding cardiovascular health but is not specific for measuring the effectiveness of lipid-lowering therapy with atorvastatin.
Correct Answer is D
Explanation
A. While historical context is useful, the development of antimicrobials primarily began in the early 20th century, notably with penicillin discovered by Alexander Fleming in 1928.
B. This statement is incorrect; fluoroquinolones primarily inhibit bacterial DNA synthesis rather than directly affecting the cell wall.
C. Selective toxicity is a principle of antimicrobial action but does not directly explain how a specific antimicrobial works therapeutically.
D. Penicillin specifically interferes with the synthesis of the bacterial cell wall, leading to cell lysis and death of the bacteria, which is a fundamental mechanism of action for this antibiotic.