Nokea
What would the nurse teach a client to avoid when taking barbiturates?
- A. Nicotine
- B. Alcohol
- C. Bananas
- D. Caffeine
- G. B
Correct Answer: Nicotine and caffeine don't critically interact. Alcohol, a CNS depressant, dangerously enhances barbiturate sedation. Bananas are unrelated.
Rationale: The correct answer is B: Alcohol. Barbiturates and alcohol are both central nervous system depressants, and when taken together, they can dangerously enhance sedation and respiratory depression. This can lead to overdose and even death. Nicotine (choice A) and caffeine (choice D) do not have critical interactions with barbiturates, so there is no specific teaching to avoid them. Bananas (choice C) are unrelated to barbiturate use and do not pose any risk. It is crucial for the nurse to educate the client on the dangers of combining barbiturates with alcohol to prevent adverse effects and ensure the client's safety.
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The risk for physical and psychological dependence is high from which class of medications, which is rarely used to treat insomnia or anxiety?
- A. Barbiturates.
- B. Nonsteroidal anti-inflammatory drugs (NSAIDs).
- C. Benzodiazepines.
- D. Selective serotonin reuptake inhibitors (SSRIs).
- G. A
Correct Answer: Barbiturates have high dependence risk and are rarely used for insomnia/anxiety due to safer alternatives like benzodiazepines. NSAIDs, benzodiazepines, and SSRIs don't fit this profile.
Rationale: The correct answer is A: Barbiturates. Barbiturates are known to have a high risk of physical and psychological dependence due to their sedative effects. They are rarely used to treat insomnia or anxiety nowadays because safer alternatives like benzodiazepines are available. Nonsteroidal anti-inflammatory drugs (NSAIDs) are primarily used for pain and inflammation, not for insomnia or anxiety. Benzodiazepines are commonly prescribed for these conditions but have a lower risk of dependence compared to barbiturates. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants and are not typically used for the treatment of insomnia or anxiety. Therefore, the correct answer is A because barbiturates have a high dependence risk and are not commonly used for these conditions.
A client taking an MAOI should be instructed to avoid which item?
- A. Large amounts of water
- B. A diet that is high in salt
- C. A diet that is high in fat
- D. Foods that contain tyramine and caffeine .
- G. D
Correct Answer: Water, salt, and fat don't interact with MAOIs. Tyramine and caffeine can cause hypertensive crises with MAOIs.
Rationale: The correct answer is D: Foods that contain tyramine and caffeine. MAOIs inhibit the breakdown of tyramine and caffeine, leading to an accumulation in the body. Tyramine can cause a dangerous increase in blood pressure known as a hypertensive crisis. Caffeine can also contribute to this effect. Large amounts of water (A), a high-salt diet (B), and a high-fat diet (C) do not interact with MAOIs in a way that poses a significant risk. Therefore, instructing the client to avoid foods containing tyramine and caffeine is crucial to prevent potential adverse reactions.
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.
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.
A nurse is caring for a client who has deep vein thrombosis. The client has been receiving IV heparin for the past 5 days and now has a new prescription for oral warfarin in addition to the heparin. The client asks the nurse if both medications are necessary. Which of the following is an appropriate response by the nurse?
- A. “Both heparin and warfarin work together to dissolve the clots.â€
- B. “I will ask the charge nurse to call your provider and get an explanation.â€
- C. “Heparin enhances the effects of the warfarin.â€
- D. “Heparin will be continued until the warfarin reaches a therapeutic level.â€
- G. D
Correct Answer: Heparin and warfarin prevent clot growth, not dissolution. No enhancement occurs. Heparin bridges until warfarin's therapeutic level is reached, typically 3 days.
Rationale: Correct Answer: D. "Heparin will be continued until the warfarin reaches a therapeutic level."
Rationale:
1. Heparin and warfarin work differently: Heparin prevents new clots, while warfarin stabilizes existing clots.
2. Transition period: Heparin is continued initially to prevent clotting while warfarin reaches its full anticoagulant effect.
3. Therapeutic level: Warfarin takes time to reach its target level for optimal clot prevention.
4. No clot dissolution: Neither heparin nor warfarin directly dissolve clots; they prevent further clot formation.
Summary of other choices:
A: Incorrect. Misleading information about clot dissolution.
B: Incorrect. Unnecessary escalation without clarifying the situation.
C: Incorrect. Misconception about the relationship between heparin and warfarin.