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A student nurse is studying drugs for anxiety and insomnia. Which of the following should be avoided as they counteract anxiolytics and sedatives and may worsen anxiety symptoms?
- A. Coffee
- B. Tea
- C. Chocolate
- D. All of the above
- G. D
Correct Answer: Coffee, tea, and chocolate contain caffeine, a stimulant that counteracts anxiolytics/sedatives and may worsen anxiety.
Rationale: The correct answer is D: All of the above. Caffeine, found in coffee, tea, and chocolate, is a stimulant that can counteract the effects of anxiolytics and sedatives, potentially worsening anxiety symptoms. Consuming these items can lead to increased heart rate, restlessness, and jitteriness, which are opposite effects of anxiolytics and sedatives. Therefore, it is advisable for a student nurse studying drugs for anxiety and insomnia to avoid these stimulant-containing products to prevent any interference with the effectiveness of anxiolytics and sedatives.
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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.
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.
A client taking an MAOI should be instructed to avoid which item?
- A. Large amounts of water
- B. A diet that is high in salt
- C. A diet that is high in fat
- D. Foods that contain tyramine and caffeine .
- G. D
Correct Answer: Water, salt, and fat don't interact with MAOIs. Tyramine and caffeine can cause hypertensive crises with MAOIs.
Rationale: The correct answer is D: Foods that contain tyramine and caffeine. MAOIs inhibit the breakdown of tyramine and caffeine, leading to an accumulation in the body. Tyramine can cause a dangerous increase in blood pressure known as a hypertensive crisis. Caffeine can also contribute to this effect. Large amounts of water (A), a high-salt diet (B), and a high-fat diet (C) do not interact with MAOIs in a way that poses a significant risk. Therefore, instructing the client to avoid foods containing tyramine and caffeine is crucial to prevent potential adverse reactions.
Which class of drugs is successful in treating an ulcer caused by H. pylori?
- A. Antacids
- B. H2-receptor blockers
- C. Antibiotics
- D. Proton-pump inhibitors
- G. C
Correct Answer: Antacids relieve symptoms. H2 blockers and PPIs reduce acid but don't kill H. pylori. Antibiotics eradicate the bacteria, treating the ulcer's cause.
Rationale: The correct answer is C: Antibiotics. Antacids (choice A) only provide symptomatic relief by neutralizing stomach acid. H2-receptor blockers (choice B) and proton-pump inhibitors (choice D) are used to reduce stomach acid secretion but do not directly target H. pylori bacteria. Choice C, antibiotics, are successful in treating ulcers caused by H. pylori because they specifically target and eradicate the bacteria, addressing the root cause of the ulcer. Therefore, antibiotics are the most effective class of drugs for treating H. pylori-induced ulcers.
After taking the medication guaifenesin (Mucinex), the client complains of coughing up phlegm. What is the best response by the nurse?
- A. This means there is probably more pathology present.
- B. This is indicative of an allergic reaction.
- C. This requires further investigation.
- D. This is a normal response to the medication.
- G. D
Correct Answer: Guaifenesin is an expectorant that loosens mucus, making coughing up phlegm a normal response. It's not indicative of more pathology, an allergic reaction, or a need for investigation unless symptoms worsen unusually.
Rationale: Step 1: Identify the medication's action - Guaifenesin is an expectorant that helps loosen and thin mucus in the airways.
Step 2: Understand the expected response - Coughing up phlegm after taking guaifenesin is a normal response due to the medication's action.
Step 3: Evaluate the other choices - A, B, and C are incorrect because coughing up phlegm is not indicative of more pathology, an allergic reaction, or a need for further investigation in this context.
Step 4: Choose the correct response - Option G correctly acknowledges that coughing up phlegm is a normal response to guaifenesin and does not suggest any unnecessary concerns or actions.