Nokea
A nurse is teaching a client who has a new prescription for Dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?
- A. Diarrhea
- B. Anxiety
- C. Sedation
- D. Palpitations
Correct Answer: C
Rationale: Dextromethorphan can cause sedation , a common side effect of this cough suppressant.
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A characteristic that distinguishes true receptors from other drug binding sites present in blood and other biological tissues is the characteristic of:
- A. binding affinity
- B. reversible binding
- C. signal transduction
- D. stereoselective interaction
Correct Answer: B
Rationale: Reversible binding is a key feature of true receptors, distinguishing them from non-specific binding sites like plasma proteins.
The nurse uses what term to describe the drug level required to have a therapeutic effect?
- A. Critical concentration
- B. Dynamic equilibrium
- C. Selective toxicity
- D. Active transport
Correct Answer: A
Rationale: A critical concentration of a drug must be present before a reaction occurs within the cells to bring about the desired therapeutic effect. A dynamic equilibrium is obtained from absorption of a drug from the site of drug entry, distribution to the active site, metabolism in the liver, and excretion from the body to have a critical concentration. Selective toxicity is the ability of a drug to attach only to those systems found in foreign cells. Active transport is the process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney.
Patients should be instructed regarding the rapid onset of zolpidem (Ambien) because:
- A. Zolpidem should be taken just before going to bed.
- B. Zolpidem may cause dry mouth and constipation.
- C. Patients may need to double the dose for effectiveness.
- D. They should stop drinking alcohol at least 30 minutes before taking zolpidem.
Correct Answer: A
Rationale: Zolpidem's rapid onset requires bedtime administration to prevent falls or amnesia.
A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
- A. The impact of the placebo effect on the patient's response.
- B. The accumulative effect of the drug if it has been taken for many years.
- C. The impact of the warmer environment on the patient's physical status.
- D. Problems with patient compliance with the drug regimen while on vacation.
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and moves to a warmer climate, there is a chance that the patient's blood pressure will drop too low, resulting in dizziness and feelings of weakness. Even mild dehydration could exacerbate these effects. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
A nurse is providing teaching to a client who is starting Simvastatin. Which of the following information should the nurse include in the teaching?
- A. Take this medication in the evening.
- B. Change position slowly when rising from a chair.
- C. Maintain a steady intake of green leafy vegetables.
- D. Consume no more than 1 L/day of fluid
Correct Answer: A
Rationale: Simvastatin is taken in the evening when cholesterol synthesis peaks.