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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.
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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.
Which of the following is a violation of safe practice when administering insulin?
- A. Administering ordered insulin subcutaneously.
- B. Using an insulin syringe to administer the insulin dose.
- C. Drawing up the ordered dose in a 3 mL syringe.
- D. Verifying the drawn-up insulin dose with another nurse.
- G. C
Correct Answer: Subcutaneous administration and insulin syringes are correct. A 3 mL syringe lacks insulin unit markings, risking errors. Verification with another nurse is a safety practice.
Rationale: The correct answer is C: Drawing up the ordered dose in a 3 mL syringe is a violation of safe practice when administering insulin. Here's a detailed rationale:
1. Administering ordered insulin subcutaneously (Choice A) is correct as insulin is typically administered subcutaneously.
2. Using an insulin syringe to administer the insulin dose (Choice B) is correct, as insulin syringes are specifically designed for accurate insulin dosing.
3. Drawing up the ordered dose in a 3 mL syringe (Choice C) is incorrect because 3 mL syringes lack insulin unit markings, increasing the risk of dosing errors.
4. Verifying the drawn-up insulin dose with another nurse (Choice D) is a safety practice and is correct to ensure accuracy and prevent errors.
In summary, choice C is incorrect because using a 3 mL syringe can lead to dosing errors, while the other choices are safe practices in administering insulin.
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 nurse is reinforcing teaching with a client who has a new prescription for buspirone (Buspar) to treat anxiety. Which of the following information should the nurse include?
- A. Take this medication on an empty stomach.
- B. Expect optimal effects within 24 hours.
- C. This medication has a low risk for dependency.
- D. Take this medication on an as-needed basis for anxiety.
- G. C
Correct Answer: No empty stomach requirement. Effects take weeks, not 24 hours. Low dependency risk is key. It's not for as-needed use.
Rationale: Correct Answer: C: This medication has a low risk for dependency.
Rationale:
1. Buspirone (Buspar) is a non-benzodiazepine anxiolytic with a lower risk of dependency compared to benzodiazepines.
2. Educating the client about the low dependency risk is crucial to alleviate fears and promote adherence.
3. Option A is incorrect as buspirone can be taken with or without food.
4. Option B is incorrect as the full therapeutic effects of buspirone may take several weeks to manifest, not within 24 hours.
5. Option D is incorrect as buspirone is typically taken regularly, not on an as-needed basis for anxiety.
Summary:
- Choice A is incorrect because buspirone can be taken with or without food.
- Choice B is incorrect because optimal effects of buspirone may take weeks, not 24 hours.
- Choice D is incorrect because buspirone is typically taken regularly, not on an
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.