Nokea
An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication?
- A. Tremors
- B. Dizziness
- C. Confusion
- D. Hallucinations
Correct Answer: C
Rationale: Cimetidine is a histamine 2 (H2)-receptor antagonist. Older clients are especially susceptible to central nervous system side effects of cimetidine. The most frequent of these is confusion. Less common central nervous system side effects include headache, dizziness, drowsiness, and hallucinations.
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Prescribers have been shown to override a medication alert about a patient's allergies when:
- A. The history showed that the patient had tolerated the medication in the past
- B. The benefit outweighed the risk
- C. The medication was therapeutically appropriate and needed
- D. All of the above
Correct Answer: D
Rationale: Prescribers may override alerts if past tolerance, benefit-risk balance, or therapeutic need justifies it.
Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms of hypoglycemia include:
- A. Fruity' breath odor and rapid respiration
- B. Diarrhea, abdominal pain, weight loss, and hypertension
- C. Dizziness, confusion, diaphoresis, and tachycardia
- D. Easy bruising, palpitations, cardiac dysrhythmias, and coma
Correct Answer: C
Rationale: Hypoglycemia presents with neuroglycopenic (dizziness, confusion) and adrenergic (diaphoresis, tachycardia) symptoms.
Which of the following is natural mineralcorticoid:
- A. Methylprednisolone
- B. Betamethasone
- C. Triamcinolone
- D. Aldosterone
Correct Answer: D
Rationale: Aldosterone is the natural mineralocorticoid produced by the adrenal cortex.
Angina pectoris, tachycardia, and arrhythmias are possible adverse effects of which of the following drugs?
- A. Clonidine
- B. Phenylephrine
- C. Propranolol
- D. Salbutamol
Correct Answer: D
Rationale: Salbutamol, a beta-2 agonist, can cause cardiac stimulation as a side effect.
A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is thinking about taking St. John's wort but wants to know if it is safe first. The nurse begins by questioning what other medications the patient takes and would be concerned about a drug-alternative drug interaction if the patient is also taking what type of medication?
- A. Antihistamines
- B. Analgesics
- C. Antibiotics
- D. Oral contraceptives
Correct Answer: D
Rationale: St. John's wort can interact with oral contraceptives that alter drug metabolism, which can decrease the effectiveness of the contraceptive. Analgesics, antibiotics, and antihistamines can be taken in combination with St. John's wort without known adverse effects.