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 A

Explanation

Choice A rationale

Beclomethasone is an inhaled corticosteroid. Gargling with water after use is essential to reduce the local deposition of the medication in the oropharynx. This minimizes the risk of developing oral candidiasis, commonly known as thrush, and hoarseness, which are common local side effects associated with inhaled corticosteroid use.

Choice B rationale

Beclomethasone, like most inhaled suspensions, requires shaking prior to use. Shaking ensures that the medication is evenly dispersed within the propellant or solution. This uniform dispersion is critical for delivering an accurate and consistent dose with each actuation, maximizing therapeutic efficacy and minimizing variability.

Choice C rationale

Beclomethasone is a long-acting inhaled corticosteroid used for the *maintenance* and *preventive* treatment of asthma. It works by reducing airway inflammation over time, not by providing immediate bronchodilation. Therefore, it is ineffective for and should not be used during an acute asthma attack, which requires a rapid-acting bronchodilator.

Choice D rationale

For optimal benefit, the short-acting bronchodilator, albuterol, should be used *before* beclomethasone. Albuterol opens the airways, allowing for better penetration of the inhaled corticosteroid into the lower respiratory tract. This sequential administration enhances the delivery and absorption of beclomethasone, improving its anti-inflammatory effects.

A. The client requests to have grapefruit juice. B. Increased serum bilirubin level. C. The client reports hair growth on their body. D. Blood pressure 128/82 mm Hg.

Correct Answer is A

Explanation

Choice A rationale

Grapefruit juice contains compounds that inhibit cytochrome P450 3A4 (CYP3A4) enzymes in the small intestine. Cyclosporine is metabolized by CYP3A4. Concomitant ingestion of grapefruit juice can lead to increased serum cyclosporine levels, raising the risk of toxicity, including nephrotoxicity and neurotoxicity.

Choice B rationale

An increased serum bilirubin level can indicate liver dysfunction, which is a potential adverse effect of cyclosporine. However, without specific values or other symptoms, this finding alone might not be an immediate emergency, though it warrants further investigation to assess liver health. Normal total bilirubin is 0.3 to 1.2 mg/dL.

Choice C rationale

Hair growth (hirsutism) is a common and recognized side effect of cyclosporine therapy, particularly in women. While it can be bothersome cosmetically, it is generally not indicative of an immediate or life-threatening adverse event and does not require urgent reporting.

Choice D rationale

A blood pressure of 128/82 mm Hg is slightly elevated but generally considered within an acceptable range, although on the higher side of normal. Cyclosporine can cause hypertension, but this specific reading does not represent a hypertensive crisis or an immediate emergency requiring urgent intervention.

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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 providing teaching to a client who has new prescriptions for beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is caring for a client who is prescribed cyclosporine. Which of the following findings should the nurse report to the provider immediately?

Correct Answer is A

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?