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A patient with frequent tension headaches asks the nurse about over-the-counter remedies. The nurse knows that Excedrin combines which of the following active ingredients to address pain, inflammation, and increased vascular tone associated with headaches?
- A. Aspirin, acetaminophen, and caffeine
- B. Ibuprofen, naproxen, and caffeine
- C. Aspirin, loratadine, and caffeine
- D. Acetaminophen, naproxen, and loratadine
Correct Answer: A
Rationale: The correct answer is A: Aspirin, acetaminophen, and caffeine. Aspirin and acetaminophen are both analgesics that help relieve pain associated with headaches. Aspirin also has anti-inflammatory properties, which can help reduce inflammation commonly associated with tension headaches. Caffeine is a vasoconstrictor, which can help reduce the vasodilation and vascular tone that contribute to headaches. Ibuprofen and naproxen (choice B) are also NSAIDs that can help with pain and inflammation, but they are not included in Excedrin. Loratadine (choices C and D) is an antihistamine used for allergies and does not address pain, inflammation, or vascular tone associated with headaches.
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A patient receiving Morphine for postoperative pain relief displays slow, shallow breathing with a rate of 8 breaths/minute. The nurse recognizes this as a side effect called:
- A. Miosis
- B. Sedation
- C. Respiratory depression
- D. Euphoria
Correct Answer: C
Rationale: The correct answer is C: Respiratory depression. Morphine is an opioid analgesic that can cause respiratory depression as a side effect by depressing the brain's respiratory center. Slow, shallow breathing with a rate of 8 breaths/minute indicates hypoventilation, a hallmark of respiratory depression. Miosis (A) refers to constricted pupils, not related to breathing. Sedation (B) may occur with morphine but does not specifically cause slow, shallow breathing. Euphoria (D) is a psychological effect and does not directly affect respiration.
When educating a patient about Lorazepam (Ativan), the nurse should advise against the concurrent use of which substance?
- A. Vitamin C supplements
- B. Caffeinated beverages
- C. Alcohol
- D. Dairy products
Correct Answer: C
Rationale: The correct answer is C: Alcohol. Lorazepam is a central nervous system depressant, and concurrent use with alcohol can potentiate sedative effects, leading to excessive drowsiness, confusion, and impaired coordination. This interaction can increase the risk of accidents and respiratory depression. Vitamin C supplements (A), caffeinated beverages (B), and dairy products (D) do not have known significant interactions with Lorazepam. It is important to advise against alcohol use to ensure the safety and effectiveness of Lorazepam therapy.
A nurse is caring for a client who is prescribed diphenhydramine to relieve pruritus. The client asks the nurse how he can minimize the daytime sedation he is experiencing. Which of the following responses should the nurse give?
- A. Distribute the doses evenly throughout the day.
- B. Take most of the daily dose at bedtime.
- C. Take the medication with meals.
- D. Gradually decrease the dose once tolerance to the effect is reached.
Correct Answer: B
Rationale: The correct answer is B: Take most of the daily dose at bedtime. Diphenhydramine is known for causing sedation, so taking most of the dose at bedtime can help minimize daytime sedation by allowing the sedative effects to occur during sleep. This strategy can help the client feel more alert during the day. Distributing the doses evenly throughout the day (choice A) may not be as effective in reducing daytime sedation as concentrating the dose at bedtime. Taking the medication with meals (choice C) is not directly related to minimizing daytime sedation. Gradually decreasing the dose once tolerance is reached (choice D) may be appropriate for long-term use but does not address the immediate concern of daytime sedation.
What does the term 'first pass effect' refer to?
- A. The initial phase of drug distribution
- B. The rapid absorption of a drug in the intestine
- C. The initial rapid excretion of a drug through the urinary system
- D. The metabolism of a drug before it reaches the systemic circulation
Correct Answer: D
Rationale: The term 'first pass effect' refers to the metabolism of a drug before it reaches the systemic circulation. This occurs when a drug is absorbed from the gastrointestinal tract and enters the liver first, where it undergoes metabolism before entering the bloodstream. This process can significantly reduce the bioavailability of the drug. The other choices are incorrect because: A. The initial phase of drug distribution does not specifically refer to metabolism in the liver. B. Rapid absorption in the intestine does not involve metabolism in the liver. C. Rapid excretion through the urinary system does not involve metabolism in the liver. Therefore, choice D is the correct answer as it specifically relates to the process of metabolism before reaching systemic circulation.
A patient who has been taking opioids for several weeks tells the nurse, 'The medication doesn't seem to work as well anymore.' The nurse recognizes this as a sign of:
- A. Allergy
- B. Addiction
- C. Withdrawal
- D. Tolerance
Correct Answer: D
Rationale: The correct answer is D: Tolerance. Tolerance occurs when the body adapts to the effects of a medication, requiring higher doses to achieve the same results. In this scenario, the patient's statement indicates a decreased response to opioids over time, which aligns with the concept of tolerance. Allergy (A) involves an immune response to a medication, which would present differently. Addiction (B) is characterized by compulsive drug-seeking behavior, not diminished effectiveness. Withdrawal (C) refers to the physical and psychological symptoms that occur when a substance is stopped suddenly, not a decreased response to the medication.