Patients should be instructed regarding the rapid onset of zolpidem (Ambien) because:
- A. Zolpidem should be taken just before going to bed.
- B. Zolpidem may cause dry mouth and constipation.
- C. Patients may need to double the dose for effectiveness.
- D. They should stop drinking alcohol at least 30 minutes before taking zolpidem.
Correct Answer: A
Rationale: Zolpidem's rapid onset requires bedtime administration to prevent falls or amnesia.
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Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because:
- A. It is a long-acting drug with potential for toxicity.
- B. Nitrate tolerance can develop.
- C. Orthostatic hypotension is a common adverse effect.
- D. It must be taken with milk or food.
Correct Answer: B
Rationale: A nitrate-free interval (e.g., after 2 p.m.) prevents tolerance.
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.
Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
- A. OTC drugs are safe and do not cause adverse effects if taken properly.
- B. OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).
- C. OTC drugs are different from any drugs available by prescription and cost less.
- D. OTC drugs could cause serious harm if not taken according to directions.
Correct Answer: D
Rationale: It is important to follow package directions because OTCs are medications that can cause serious harm if not taken properly. OTCs are drugs that have been determined to be safe when taken as directed; however, all drugs can produce adverse effects even when taken properly. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC education should always be included as a part of the hospital discharge instructions.
The Alkaline Drug (Amidopy rine) is absorbed from
- A. Stomach
- B. Proximal small intestine
- C. Distal small intestine
- D. Colon
Correct Answer: B
Rationale: Basic drugs like amidopyrine are ionized in the stomach (acidic pH) and absorbed in the small intestine (neutral pH).
You are gathering assessment data from a medication history of a 38-year-old male with four children. What assessment information would be most important in providing care for this patient?
- A. The medication history of the patient's mother and/or father
- B. The name of the patient's pharmacy
- C. Insurance, financial support, and stability for the patient and his family
- D. The last time the patient was hospitalized
Correct Answer: C
Rationale: Insurance and financial stability impact access to medications and adherence, critical for a 38-year-old with family responsibilities.
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