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A nurse is reinforcing teaching with a client who was newly prescribed paroxetine (Paxil) (an SSRI) for treatment of panic disorder. Sort the following information by what the nurse should include vs what not to include.
- A. Take this medication just before bedtime to promote sleep.
- B. Herbal medication can be combined with this medication.
- C. Monitor for weight changes while taking this medication.
- D. It can take several weeks before you feel like the medication is helping.
- G. A,C
Correct Answer: Bedtime dosing helps with side effects like drowsiness. Herbal combinations risk serotonin syndrome and should be avoided. Weight changes are a side effect to monitor. It takes weeks for full effect, but this was mislabeled; A and C are correct inclusions.
Rationale: The correct answer is G: A,C. The rationale for this is as follows:
1. A: Taking the medication just before bedtime can help minimize side effects like drowsiness, which is common with SSRIs like paroxetine.
2. C: Monitoring for weight changes is important because weight gain or loss can be a side effect of paroxetine.
3. B: Combining herbal medications with paroxetine can increase the risk of serotonin syndrome, a potentially life-threatening condition.
4. D: It is true that it can take several weeks before feeling the full benefits of paroxetine, but this information was not provided in the question stem.
In summary, A and C are the correct inclusions because they provide important information related to the medication's side effects and administration, while B and D are incorrect because they introduce potential risks and irrelevant information.
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Why are antianxiety medications used cautiously in older adults?
- A. The drug is not distributed as well due to poor circulation.
- B. The liver metabolizes the drug faster, making it ineffective.
- C. There is an inability to absorb the drugs due to decreased acid production.
- D. There is reduced elimination, leading to a buildup in the circulation.
- G. D
Correct Answer: Poor circulation affects distribution but isn't primary. Liver metabolism slows, not hastens. Acid production impacts some drugs, not anxiolytics. Reduced elimination increases buildup, risking side effects.
Rationale: The correct answer is D: There is reduced elimination, leading to a buildup in the circulation. In older adults, the kidneys tend to function less efficiently, resulting in reduced elimination of medications from the body. This decreased clearance can lead to a buildup of antianxiety medications in the bloodstream, potentially causing adverse effects or toxicity. This is why antianxiety medications should be used cautiously in older adults to prevent these risks.
Choices A, B, and C are incorrect because poor circulation, faster liver metabolism, and decreased acid production are not the primary reasons why antianxiety medications are used cautiously in older adults. These factors may influence drug absorption or metabolism, but the key concern with antianxiety medications in older adults is the reduced elimination leading to potential drug accumulation and its associated risks.
Class of drugs derived from barbituric acid that act as CNS depressants and are used for their sedative and anti- seizure effect are known as _
- A. Antidepressants
- B. Anxiolytics
- C. Barbiturates
- D. Benzodiazepines
- G. C
Correct Answer: Antidepressants treat mood disorders. Anxiolytics reduce anxiety but aren't barbituric-derived. Barbiturates fit the description. Benzodiazepines aren't barbituric-based.
Rationale: The correct answer is C: Barbiturates. Barbiturates are drugs derived from barbituric acid, acting as CNS depressants for sedative and anti-seizure effects. Antidepressants (A) are used for mood disorders, not CNS depression. Anxiolytics (B) are for anxiety and not all are barbituric-derived. Benzodiazepines (D) are a different class of CNS depressants, not derived from barbituric acid. Therefore, choice C is the most appropriate based on the specific description provided in the question.
The risk for physical and psychological dependence is high from which class of medications, which is rarely used to treat insomnia or anxiety?
- A. Barbiturates.
- B. Nonsteroidal anti-inflammatory drugs (NSAIDs).
- C. Benzodiazepines.
- D. Selective serotonin reuptake inhibitors (SSRIs).
- G. A
Correct Answer: Barbiturates have high dependence risk and are rarely used for insomnia/anxiety due to safer alternatives like benzodiazepines. NSAIDs, benzodiazepines, and SSRIs don't fit this profile.
Rationale: The correct answer is A: Barbiturates. Barbiturates are known to have a high risk of physical and psychological dependence due to their sedative effects. They are rarely used to treat insomnia or anxiety nowadays because safer alternatives like benzodiazepines are available. Nonsteroidal anti-inflammatory drugs (NSAIDs) are primarily used for pain and inflammation, not for insomnia or anxiety. Benzodiazepines are commonly prescribed for these conditions but have a lower risk of dependence compared to barbiturates. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants and are not typically used for the treatment of insomnia or anxiety. Therefore, the correct answer is A because barbiturates have a high dependence risk and are not commonly used for these conditions.
A nurse is assisting with the care of four clients who have peptic ulcer disease. The nurse should identify that misoprostol (Cytotec) is contraindicated for which of the following clients?
- A. A client who is pregnant.
- B. A client who has osteoarthritis.
- C. A client who has a urinary tract infection.
- D. A client who has a kidney stone.
- G. A
Correct Answer: Misoprostol can induce labor or miscarriage, making it contraindicated in pregnancy. It's safe for osteoarthritis, UTIs, and kidney stones as it doesn't interact adversely with these conditions.
Rationale: Correct Answer: A. A client who is pregnant.
Rationale: Misoprostol is contraindicated in pregnancy as it can induce labor or miscarriage due to its uterotonic effects. This medication is used to prevent gastric ulcers in patients taking NSAIDs, not for conditions like osteoarthritis, urinary tract infection, or kidney stones. Thus, it is important to avoid its use in pregnant individuals to prevent harm to the fetus.
Summary of Other Choices:
B: Misoprostol is safe for a client with osteoarthritis as it does not pose any specific risks or contraindications for this condition.
C: Misoprostol does not interact adversely with urinary tract infections, so it is safe for a client with this condition.
D: Misoprostol does not have any contraindications for kidney stones; therefore, it is safe for a client with this condition.
Complete the following statement: “Drugs used for the treatment of depression and a range of anxiety disorders including panic, social phobia, and post-traumatic stress disorder are known as…â€
- A. Barbiturates
- B. Rebound insomnia
- C. Antidepressants
- D. Anxiolytics
- G. C
Correct Answer: Barbiturates are sedatives. Rebound insomnia isn't a drug. Antidepressants treat depression and anxiety disorders. Anxiolytics focus on anxiety.
Rationale: The correct answer is C: Antidepressants. Antidepressants are drugs specifically designed to treat depression and various anxiety disorders, including panic, social phobia, and post-traumatic stress disorder. They work by balancing neurotransmitters in the brain to improve mood and reduce symptoms of anxiety. Barbiturates (A) are sedatives, not typically used for treating anxiety or depression. Rebound insomnia (B) is a phenomenon where insomnia worsens after discontinuing sleep medications, not a class of drugs. Anxiolytics (D) are drugs that specifically target anxiety symptoms, but they do not usually address depression. Therefore, the correct choice is C as it accurately describes the drugs used for treating depression and a range of anxiety disorders.