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A teenage client is taking duloxetine (Cymbalta) for a generalized anxiety disorder. The dose has been changed by the physician. What adverse effects will the nurse advise the client and family to watch?
- A. Warning signs of suicide.
- B. Fatigue.
- C. Irritability.
- D. Weight gain.
- G. A,B,C
Correct Answer: Suicidal thoughts are a risk, especially in teens with dose changes. Fatigue and irritability are common. Weight gain is possible but less urgent to monitor than A, B, C.
Rationale: The correct answer is G: A, B, C. When a teenage client is taking duloxetine for generalized anxiety disorder and the dose has been changed, the nurse should advise the client and family to watch for warning signs of suicide (A) because duloxetine can increase the risk of suicidal thoughts, especially in teens with dose changes. Fatigue (B) and irritability (C) are common side effects of duloxetine and should also be monitored closely. While weight gain (D) is a possible side effect of duloxetine, it is less urgent to monitor compared to the risk of suicidal thoughts, fatigue, and irritability. Therefore, choices A, B, and C are the most important adverse effects to watch for in this scenario.
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In which of the following conditions should decongestants be used with caution?
- A. Diabetes
- B. Hypertension
- C. Allergic rhinitis
- D. Hyperthyroidism
- G. B
Correct Answer: Diabetes isn't a primary caution. Hypertension risks elevation from vasoconstriction. Allergic rhinitis is a treatment target. Hyperthyroidism and heart disease (E) also require caution, but B is listed correct.
Rationale: The correct answer is B: Hypertension. Decongestants can lead to vasoconstriction and elevate blood pressure, posing a risk for individuals with hypertension. Diabetes (A) is not a primary concern with decongestants. Allergic rhinitis (C) is a condition where decongestants are often used as a treatment. Hyperthyroidism (D) can have cardiovascular effects and should also be used with caution. However, the primary caution for decongestant use is hypertension due to the potential for exacerbating high blood pressure.
The patient with tuberculosis is now on isoniazid (INH). Which laboratory test should the nurse monitor?
- A. BUN
- B. PT and PTT
- C. Liver enzymes (LFTs)
- D. CBC
- G. C
Correct Answer: BUN, PT/PTT, and CBC aren't specific to INH. Liver enzymes are monitored due to INH's hepatotoxicity risk.
Rationale: The correct answer is C. The nurse should monitor liver enzymes (LFTs) in a patient on isoniazid (INH) due to the risk of hepatotoxicity associated with this medication. 1. Isoniazid is known to cause liver damage in some patients. 2. Monitoring liver enzymes can help detect any liver dysfunction early. 3. LFTs include tests such as ALT, AST, and bilirubin, which can indicate liver damage. 4. Regular monitoring of LFTs is essential to ensure the safe use of INH. Incorrect choices: A. BUN is not specific to INH. B. PT and PTT are not directly related to INH use. D. CBC is not specifically required for monitoring INH therapy.
How does drug therapy of tuberculosis differ from that of most other infections?
- A. Patients with tuberculosis have no symptoms.
- B. Antituberculosis drugs are used extensively for treating active disease, not prevention.
- C. Patients usually require therapy for a shorter period.
- D. Mycobacteria have a cell wall that is resistant to penetration by anti-infective drugs.
- G. D
Correct Answer: TB patients can have symptoms. Drugs treat both active disease and prevention (latent TB). TB therapy is longer (6-9 months+). Mycobacteria's resistant cell wall necessitates prolonged, combined drug therapy.
Rationale: The correct answer is G. The rationale is as follows:
1. TB patients can have symptoms: TB can present with symptoms such as cough, fever, weight loss, and night sweats.
2. Drugs treat both active disease and prevention: Antituberculosis drugs are used for both treating active TB disease and preventing latent TB from developing into active disease.
3. TB therapy is longer: TB therapy typically lasts 6-9 months or longer due to the slow-growing nature of Mycobacterium tuberculosis and the need to prevent drug resistance.
4. Mycobacteria's resistant cell wall: Mycobacteria have a unique cell wall that is resistant to penetration by many antibiotics, necessitating prolonged and combined drug therapy for effective treatment.
In summary, the other choices are incorrect because patients with TB can have symptoms, antituberculosis drugs are used for both treatment and prevention, therapy duration is usually longer, and the unique cell wall of Mycobacteria requires specific drug regimens.
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 nurse is caring for a patient who is experiencing anaphylaxis. The family asks the nurse why the patient is having difficulty breathing. The nurse responds based on what knowledge?
- A. Bronchoconstriction in response to the allergen.
- B. Compensation for a rapid fall in blood pressure.
- C. Reflex tachycardia.
- D. Seizures are likely to occur.
- G. A
Correct Answer: Bronchoconstriction from allergens causes breathing difficulty in anaphylaxis. Hypotension, tachycardia, and seizures are secondary or unrelated.
Rationale: The correct answer is A: Bronchoconstriction in response to the allergen. During anaphylaxis, the body releases histamine causing bronchoconstriction, leading to difficulty breathing. This is a direct response to the allergen and can lead to respiratory distress. Choice B, compensation for a rapid fall in blood pressure, is incorrect as hypotension is a secondary effect of anaphylaxis. Choice C, reflex tachycardia, is also incorrect as tachycardia is a compensatory response to hypotension, not the cause of difficulty breathing. Choice D, seizures are likely to occur, is incorrect as seizures are not a common manifestation of anaphylaxis. Therefore, the correct answer is A as it directly relates to the pathophysiology of anaphylaxis.