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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.
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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.
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.
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.
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.
Complete the following statement: “Drugs used for the treatment of depression and a range of anxiety disorders including panic, social phobia, and post-traumatic stress disorder are known as…â€
- A. Barbiturates
- B. Rebound insomnia
- C. Antidepressants
- D. Anxiolytics
- G. C
Correct Answer: Barbiturates are sedatives. Rebound insomnia isn't a drug. Antidepressants treat depression and anxiety disorders. Anxiolytics focus on anxiety.
Rationale: The correct answer is C: Antidepressants. Antidepressants are drugs specifically designed to treat depression and various anxiety disorders, including panic, social phobia, and post-traumatic stress disorder. They work by balancing neurotransmitters in the brain to improve mood and reduce symptoms of anxiety. Barbiturates (A) are sedatives, not typically used for treating anxiety or depression. Rebound insomnia (B) is a phenomenon where insomnia worsens after discontinuing sleep medications, not a class of drugs. Anxiolytics (D) are drugs that specifically target anxiety symptoms, but they do not usually address depression. Therefore, the correct choice is C as it accurately describes the drugs used for treating depression and a range of anxiety disorders.