If 2 liters of a parenteral fluid is to be infused over a 14-hour period using an infusion set that delivers 20 drops/mL, (1) should be the rate of flow in drops per minute.

The body stores energy in various forms to ensure a constant supply of fuel during fasting or high metabolic demand. These macronutrients differ in their chemical structure and the amount of energy released upon complete oxidative catabolism. Energy density is measured in kilocalories per gram (kcal/g). Efficient storage is necessary to minimize the physical mass of the body's energy reserves.

Rationale:

A. Fat (lipids) possesses the highest energy density at approximately 9 kcal/g. This is because fatty acid chains are highly reduced hydrocarbons, allowing them to release more energy when oxidized to CO2 and water. Furthermore, fat is stored in a relatively anhydrous (water-free) state, maximizing the caloric value per unit of mass.

B. Carbohydrates provide approximately 4 kcal/g of energy. They are stored as glycogen in the liver and skeletal muscle. Glycogen is a hydrophilic molecule and is stored with a significant amount of water, which greatly reduces the overall energy-to-weight ratio compared to the dense storage found in adipose tissue.

C. This choice is scientifically incorrect as the macronutrients do not provide equal energy. The caloric yield is determined by the oxidation state of the carbon atoms in the molecule. Fats are significantly more energy-dense than both proteins and carbohydrates, yielding more than double the energy per gram than the other two.

D. Protein also provides approximately 4 kcal/g of energy. While the body can use protein for energy through gluconeogenesis or direct oxidation of carbon skeletons, it is primarily used for structural and functional purposes. Using protein as a primary energy store is inefficient and leads to the loss of muscle mass.

Intranasal administration of corticosteroids or decongestants requires specific techniques to maximize mucosal absorption and minimize systemic ingestion. Proper positioning and preparation ensure the drug reaches the turbinates rather than the pharynx. Effective delivery relies on the medication remaining in contact with the nasal mucosa for a sufficient duration. Errors in technique, such as improper sniffing or nose blowing, can significantly reduce the therapeutic efficacy of the treatment.

Rationale:

A. True is incorrect because blowing the nose after administration would mechanically remove the medication from the nasal cavity. The goal of the spray is to facilitate local absorption through the respiratory epithelium. If the patient clears their nose immediately after spraying, the active ingredients are expelled, resulting in a sub-therapeutic dose and poor symptom control for the patient.

B. False is the correct answer because while patients should blow their nose before administration to clear mucus, they must avoid doing so afterward. Clearing the passages initially allows for better surface contact with the medication. However, after the dose is given, the patient should avoid blowing their nose for at least 15 minutes to ensure the drug is fully absorbed.