A population study of gentamicin pharmacokinetics in 425 neonates reported the following correlation by least-squares linear regression between gestational age and gentamicin clearance:
r2 = 0.35, p = 0.0001. Which of the following is the most appropriate interpretation of these data?

• A. A significant correlation exists between gestational age of newborns and gentamicin clearance, but gestational age accounts for only 35% of the variability in clearance.
• B. A significant correlation exists between gestational age and gentamicin clearance, with gestational age accounting for 59% of the variability of gentamicin clearance.
• C. A significant correlation exists between gestational age and gentamicin clearance, with gestational age accounting for 65% of the variability in gentamicin clearance.
• D. A correlation coefficient of less than 0.8 essentially means no significant relationship exists between gestational age and gentamicin clearance in neonates.

An obtunded 61-year-old Woman weighing 45 kg with Worsening renal function is admitted to the hospital. She has a recent history of several days of nausea, fatigue, pruritus, and a metallic taste in her mouth. Her medical history includes diabetes, heart failure, and COPD. Admission laboratory values include:
SERUM CHEMISTRY
Sodium: 135 mEq/L
Potassium: 5.7 mEq/L
Chloride: 100 mEq/L
HCO3: 15 mEq/L
BUN: 96 mg/dL
Creatinine: 5.5 mg/dL
Glucose: 300 mg/dL
Calcium: 7.4 mg/dL
Serum ketones: Negative
ABGS (Room Air)
pH: 72
PaCO2: 30 mm Hg
PaO2: 75 mm Hg
O2 Sat: 90%
Chest X-ray shows a flattened diaphragm. Current medications include furosemide, fluticasone salmeterol, and glipizide. Which acid-base disorder does this patient exhibit?

• A. Metabolic acidosis secondary to furosemide use
• B. Metabolic acidosis secondary to diabetic ketoacidosis
• C. Metabolic acidosis secondary to end-stage renal disease
• D. Respiratory acidosis secondary to COPD

A 60-year-old man with heart failure states that he becomes "a bit short of breath" after climbing a flight of stairs. His ejection fraction is 40%. Current medications include lisinopril 5 mg daily, metoprolol XL 100 mg daily, aspirin 81 mg daily, furosemide 40 mg daily, and digoxin
250 mcg daily. All vital signs and laboratory values are stable and within normal limits. Which of the following recommendations would be most appropriate at this time?

• A. Add Valsartan 80 mg twice daily.
• B. Add spironolactone 25 mg daily.
• C. Replace aspirin with clopidogrel 75 mg daily.
• D. Increase lisinopril to 10 mg daily.

A patient asks for advice relative to an herbal supplement to treat heart failure. The patient is currently NYHA Class III (LVEF 25%) and is adherent to medications, which include digoxin
0.25 mg daily, furosemide 40 mg daily, lisinopril 10 mg daily, carvedilol 6.25 mg twice daily, potassium 20 mEq daily, and simvastatin 40 mg nightly.
The patient has BP of 120/78 mm Hg, HR of 60 bpm, 9 cm JVD, 2+ pitting edema, and has experienced a 2.3 kg weight gain in last 2 days. All laboratory values are within normal limits.
Based on the following information, what is the most appropriate suggestion for the patient?

• A. Omega-3-fatty acid
• B. Coenzyme Q10
• C. Avoidance of dietary supplements
• D. L-Carnitine