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The nurse, providing patient teaching about home medication use to an older adult, explains that even when drugs are taken properly they can produce negative or unexpected effects. What are these negative or unexpected effects called?
- A. Teratogenic effects
- B. Toxic effects
- C. Adverse effects
- D. Therapeutic effects
Correct Answer: C
Rationale: Negative or unexpected effects are known as adverse or side effects. Teratogenic effects are adverse effects on the fetus and not a likely concern for an older adult. Toxic effects occur when medication is taken in larger than recommended dosages caused by an increase in serum drug levels. Therapeutic effects are the desired actions for which the medication is prescribed.
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The nurse is assessing a diabetic patient who has presented at the clinic reporting several hypoglycemic episodes during the past 3 weeks. The nurse questions the patient about the use of herbal or alternative therapies, suspecting what herbal remedy could cause the hypoglycemic episodes?
- A. St. John's wort
- B. Kava
- C. Fish oil
- D. Ginseng
Correct Answer: D
Rationale: Ginseng is known to decrease blood sugar levels. If the patient used this in combination with his or her oral antidiabetic agent, diet, and exercise, his or her blood sugar could drop below therapeutic levels. St. John's wort interacts with many drugs, but not with antidiabetic agents. Kava is associated with liver toxicity. Fish oil has been associated with decreased coronary artery disease.
A nurse is caring for a client who states she has been taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?
- A. Sedation
- B. Nasal congestion
- C. Productive cough
- D. Constipation
Correct Answer: B
Rationale: Prolonged phenylephrine use can cause rebound nasal congestion due to vasoconstrictor overuse.
A nurse is preparing to administer Propranolol to a client who has a dysrhythmia. Which of the following actions should the nurse plan to take?
- A. Hold propranolol for an apical pulse greater than 100/min.
- B. Administer propranolol to increase the client's blood pressure.
- C. Assist the client when she sits up or stands after taking this medication.
- D. Check for hypokalemia frequently due to the risk for propranolol toxicity.
Correct Answer: C
Rationale: Propranolol can cause orthostatic hypotension; assisting with position changes prevents falls.
Which of the following sign/symptom would NOT be expected from organophosphate poisoning?
- A. Dry skin and mucous membranes
- B. Increased salivation
- C. Increased bowel sounds
- D. Urinary urgency
Correct Answer: A
Rationale: Organophosphates cause wet symptoms (salivation, etc.); dry skin is typical of anticholinergics.
Pharmacokinetic factors that affect prescribing include:
- A. Therapeutic index
- B. Minimum effective concentration
- C. Bioavailability
- D. Ease of titration
Correct Answer: C
Rationale: Bioavailability directly impacts how much drug reaches circulation, a key pharmacokinetic factor, unlike therapeutic index or titration ease .