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H2-receptor antagonists decrease acid by which of the following mechanisms?

An 87-year-old male residing in a skilled nursing facility is evaluated for constipation. He requires assistance with toileting, has advanced dementia, and is at high risk for falls. He has not had a bowel movement in 4 days, and constipation has been a recurrent issue. Past medical history includes chronic kidney disease stage 3b and hypertension. He is eating and drinking with assistance. Abdominal exam is benign with no signs of obstruction. The facility nurse asks which pharmacologic option is contraindicated for this patient.

All of the patient characteristics below require that bulk-forming laxatives be used with caution EXCEPT?

A 32-year-old female with a 5-year history of ulcerative colitis presents to your family practice clinic with a 3-week history of worsening abdominal cramping, urgency, and 6–8 bloody stools per day. She reports fatigue and unintentional weight loss. She has been maintained on oral mesalamine with good control until recently. Vital signs are stable. Labs show mild anemia and elevated CRP. Stool studies are negative for infection. Colonoscopy performed last year showed moderate left-sided disease. She has never received immunomodulators or biologic therapy. You initiate oral prednisone for induction of remission. After 4 weeks, her symptoms improve, but she develops recurrent symptoms during steroid tapering. Which finding indicates the need to escalate therapy beyond glucocorticoids?

Which class of antiemetic is well absorbed orally, has a rapid onset of action, and prevents serotonin-mediated activation of the vomiting reflex by blocking 5-HT₃ receptors? Please include drug class and one drug example.

Based on the 32-yo female above with ulcerative colitis, What is the most appropriate next action by the FNP?

For Questions 3a, 3b, 3c and 3d. Suppose you have two assemblies: Assembly A has an aluminum hex nut screwed onto a steel bolt and assembly B has a steel hex nut screwed onto an aluminum bolt. The coefficient of linear expansion (per degree C) for aluminum is 25 x 10^-6 and for steel it is 12 x 10^-6.

Name two CLASSES of pharmacologic treatment options for BPH including an example agent, MOA, and most common side effect. 

A 44-year-old female with a history of hypertension, GERD, depression, and overactive bladder is taking lisinopril, losartan, famotidine, escitalopram, and oxybutynin. She presents with a new complaint of blurred vision that began after starting a recent medication. She denies eye pain or headache. Question:Which medication is the most likely cause of this patient’s blurred vision?

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