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A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)
- A. Increased renal secretion
- B. Increased medication-metabolizing enzymes
- C. Liver failure
- D. Peripheral vascular disease
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Most antibiotic resistance in bacteria is caused by which of the following?
- A. Genes that are carried on plasmids
- B. Depression of a previously existing gene pool
- C. An ever increasing mutation rate in bacteria
- D. Unequal distribution of antibiotics into body spaces
Correct Answer: A
Rationale: Antibiotic resistance in bacteria is commonly caused by genes that are carried on plasmids. Plasmids are small, circular DNA molecules that can be transferred between bacteria, allowing for the rapid spread of antibiotic resistance genes throughout bacterial populations. These resistance genes can encode enzymes that inactivate antibiotics, alter antibiotic targets, or even pump antibiotics out of bacterial cells. Plasmid-mediated resistance is a major concern in the healthcare setting as it can lead to the development of multi-drug resistant bacteria, making infections harder to treat. Therefore, the presence and transfer of genes on plasmids play a significant role in the development of antibiotic resistance in bacteria.
When teaching a client with a new prescription for Lisinopril, which instruction should the nurse include?
- A. Take the medication with food.
- B. Expect a persistent, dry cough.
- C. Increase your intake of potassium-rich foods.
- D. Take the medication at bedtime.
Correct Answer: B
Rationale: The correct answer is B: 'Expect a persistent, dry cough.' Lisinopril, an ACE inhibitor, commonly causes a persistent, dry cough as a side effect. This should be reported to the healthcare provider if it becomes bothersome. It is essential for the nurse to educate the client about this potential side effect so the client is aware and can seek appropriate guidance if needed.
What is the therapeutic class of Valproate?
- A. Anticoagulant
- B. Antianxiety, benzodiazepines
- C. Anticonvulsant, vascular headache suppressant
- D. Mood stabilizer
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is prescribed Amitriptyline for depression. What should the nurse include in the teaching? (Select all that apply.)
- A. Expect therapeutic effects in 24 to 48 hours.
- B. Discontinue the medication after a week of improved mood.
- C. Change positions slowly to minimize dizziness.
- D. Decrease dietary fiber intake to control diarrhea.
Correct Answer: C
Rationale: The correct answer is C. Changing positions slowly can help prevent orthostatic hypotension, a common adverse effect of tricyclic antidepressants like Amitriptyline. It is essential to educate the client to avoid sudden position changes to minimize the risk of dizziness and falls. Choices A, B, and D are incorrect. Therapeutic effects of Amitriptyline may not be noticeable for 1-3 weeks, so expecting them in 24 to 48 hours (choice A) is unrealistic. Discontinuing the medication abruptly can lead to withdrawal symptoms and should be done gradually under healthcare provider supervision, so choice B is incorrect. Amitriptyline can actually cause constipation, so decreasing dietary fiber intake would not be recommended to control diarrhea, making choice D incorrect.
A patient is taking oral acetazolamide, a carbonic anhydrase inhibitor, to decrease intraocular pressure. When providing drug education, which side effect will the nurse advise the patient to anticipate?
- A. Increased weight
- B. Light sensitivity
- C. Burning or stinging of the eyes
- D. Increased urine output
Correct Answer: D
Rationale: Acetazolamide, a carbonic anhydrase inhibitor, promotes diuresis by inhibiting the reabsorption of bicarbonate in the kidneys, leading to increased urine output. This is a common side effect that patients should be informed about. Increased weight (A) is not typically associated with acetazolamide. Light sensitivity (B) and burning or stinging of the eyes (C) are more commonly associated with topical ophthalmic medications, not systemic acetazolamide.