Nokea
A patient who started taking orlistat 1 month ago calls the clinic to report some 'embarrassing' adverse effects. She tells the nurse that she has had episodes of 'not being able to control my bowel movements.' Which statement is true about this situation?
- A. These are expected adverse effects that will eventually diminish.
- B. The patient will need to stop this drug immediately if these adverse effects are occurring.
- C. The patient will need to increase her fat intake to prevent these adverse effects.
- D. The patient will need to restrict fat intake to less than 30% of total calories to help reduce these adverse effects.
Correct Answer: D
Rationale: Orlistat's gastrointestinal side effects, such as fecal incontinence, are related to its mechanism of inhibiting fat absorption. Restricting dietary fat to less than 30% of total calories can reduce these effects. They are not expected to diminish entirely without dietary changes, stopping the drug is not necessary, and increasing fat intake would worsen the effects.
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A patient has just received an injection of onabotulinumtoxin A. The nurse will monitor for which adverse effects? (Select all that apply.)
- A. Insomnia
- B. Dysphagia
- C. Weight gain
- D. GI upset
- E. Difficulty breathing
Correct Answer: B,E
Rationale: Onabotulinumtoxin A (Botox) carries a Black Box Warning for toxin spread beyond the injection site, which may cause dysphagia and breathing difficulties. Insomnia, weight gain, and GI upset are not commonly associated adverse effects.
A patient is receiving instructions regarding the use of caffeine. The nurse shares that caffeine should be used with caution if which of these conditions is present?
- A. A history of peptic ulcers
- B. Migraine headaches
- C. Asthma
- D. A history of kidney stones
Correct Answer: A
Rationale: Caffeine can exacerbate peptic ulcers by increasing gastric acid secretion, which may worsen the condition. It is not contraindicated in migraine headaches, asthma, or kidney stones, though it may have varying effects on these conditions.
A 22-year-old nursing student has been taking caffeine tablets for the past few weeks to 'make it through' the end of the semester and exam week. She is in the university clinic today because she is 'exhausted.' What human needs statement may be appropriate for her?
- A. Altered oxygenation need
- B. Altered physical activity
- C. Altered need for sleep
- D. Altered food intake
Correct Answer: C
Rationale: Caffeine, a CNS stimulant, can cause restlessness, anxiety, and insomnia, leading to an altered need for sleep. This is the most relevant human needs statement given her exhaustion from overuse. The other options are not directly related to caffeine's effects.
The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.)
- A. Narcolepsy
- B. Depression
- C. Panic attacks
- D. Neonatal apnea
- E. Attention deficit hyperactivity disorder (ADHD)
- F. Appetite suppression
- G. Migraine headaches
Correct Answer: A,D,E,F,G
Rationale: CNS stimulants are indicated for narcolepsy, neonatal apnea, ADHD, appetite suppression in obesity treatment, and migraine headaches (via triptans). They are not used for depression or panic attacks, as they may worsen these conditions.
The order reads: 'Give atomoxetine 0.5 mg/kg/day once daily in the morning before school.' The child weighs 88 pounds. Identify how many milligrams will be administered per dose.
Correct Answer: 20 mg
Rationale: Convert 88 pounds to kilograms: 88 ?· 2.2 = 40 kg. Calculate dose: 0.5 mg/kg/day ?? 40 kg = 20 mg/day.