A nurse is assessing a client who has a prescription for oral albuterol for the long-term management of asthma.
For which of the following adverse effects should the nurse monitor?

Nystagmus.

Tachycardia.

Drowsiness.

Oral fungal infections.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Nystagmus, an involuntary rhythmic eye movement, is not a recognized or common adverse effect of oral albuterol. Albuterol is a beta-2 adrenergic agonist primarily acting on bronchial smooth muscle to cause bronchodilation. Its side effects are typically related to sympathetic nervous system stimulation, not oculomotor dysfunction.

Choice B rationale

Tachycardia is a common adverse effect of oral albuterol due to its systemic absorption and stimulation of beta-1 adrenergic receptors in the heart, in addition to its primary beta-2 effects on the lungs. This leads to an increased heart rate (normal range 60-100 bpm) and can cause palpitations, especially in sensitive individuals or with higher doses.

Choice C rationale

Drowsiness is not a typical adverse effect of oral albuterol. In fact, due to its stimulant properties, albuterol is more likely to cause central nervous system excitation, leading to insomnia, nervousness, or tremors rather than sedation. Its action is to activate adrenergic pathways, which generally promote alertness.

Choice D rationale

Oral fungal infections, such as oral candidiasis (thrush), are commonly associated with inhaled corticosteroids, not oral albuterol. Inhaled corticosteroids suppress the local immune response in the oral cavity, allowing opportunistic fungal growth. Oral albuterol does not have immunosuppressive effects on the oral mucosa.

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Correct Answer is C

Explanation

Choice A rationale

Metoprolol is a beta-blocker primarily used to treat hypertension, angina, and heart failure. It works by blocking beta-adrenergic receptors, leading to decreased heart rate and blood pressure. It is not indicated for managing tremors or dyskinesias associated with levodopa/carbidopa therapy in Parkinson's disease, as these are typically dopaminergic in origin.

Choice B rationale

Bethanechol is a muscarinic cholinergic agonist that increases bladder tone and stimulates gastrointestinal motility. It is primarily used for urinary retention and gastroesophageal reflux disease. Its mechanism involves directly stimulating muscarinic receptors. It has no role in addressing the motor complications like tremors and twitching seen with levodopa/carbidopa in Parkinson's disease.

Choice C rationale

Amantadine is an antiviral drug also used to treat dyskinesia associated with levodopa therapy in Parkinson's disease. Its precise mechanism of action in Parkinson's is not fully understood, but it is thought to modulate dopaminergic and glutamatergic neurotransmission. It can help reduce tremors, rigidity, and involuntary movements.

Choice D rationale

Gabapentin is an anticonvulsant and neuropathic pain medication. It is structurally related to GABA but does not act directly on GABA receptors. Its mechanism of action involves modulating calcium channels. While it can treat some neurological symptoms, it is not a primary treatment for levodopa-induced tremors and twitching in Parkinson's disease.

A. Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide. B. You might need to decrease your insulin dosage while taking hydrochlorothiazide. C. Hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes. D. Reducing sodium in your diet while taking hydrochlorothiazide will help control your blood glucose.

Correct Answer is C

Explanation

Choice A rationale

Blood glucose monitoring accuracy is generally not directly affected by hydrochlorothiazide. The medication's impact is on glucose metabolism itself, not the accuracy of the measurement device. Hydrochlorothiazide affects the pancreatic beta cells or peripheral insulin sensitivity, leading to altered glucose homeostasis, not erroneous readings from a glucometer.

Choice B rationale

Decreasing insulin dosage is generally not appropriate when taking hydrochlorothiazide. Hydrochlorothiazide, a thiazide diuretic, can induce hyperglycemia by impairing insulin secretion from the pancreatic beta cells or by reducing peripheral glucose utilization, thereby requiring an *increase* in insulin dosage to maintain glycemic control, not a decrease.

Choice C rationale

Hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes. This effect is attributed to the medication's ability to impair insulin secretion from pancreatic beta cells or to decrease peripheral glucose utilization, leading to insulin resistance. This necessitates careful blood glucose monitoring (normal fasting glucose <100 mg/dL).

Choice D rationale

Reducing sodium in the diet while taking hydrochlorothiazide is beneficial for blood pressure control by augmenting the diuretic's effects, but it does not directly control blood glucose levels. While a healthy diet supports overall health, the primary mechanism of glucose elevation from hydrochlorothiazide is metabolic, not sodium-related.

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A nurse is assessing a client who has a prescription for oral albuterol for the long-term management of asthma. For which of the following adverse effects should the nurse monitor?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has Parkinson's disease and is taking levodopa/carbidopa. The nurse observes that the client has tremors and twitching. Which of the following medications should the nurse anticipate administering?

Correct Answer is C

Explanation

A nurse is providing teaching to a client who has a history of diabetes mellitus and a new prescription for hydrochlorothiazide to treat uncontrolled hypertension. Which of the following information should the nurse include in the teaching?

Correct Answer is C

Explanation

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A nurse is assessing a client who has a prescription for oral albuterol for the long-term management of asthma.
For which of the following adverse effects should the nurse monitor?