A nurse is reviewing the medication regimen of a 65-year-old patient with multiple comorbidities. The patient's current medications include:
- Metoprolol 50 mg PO BID for Hypertension
- Triazolam 0.25 mg PO at Bedtime for Insomnia
- Sertraline 50 mg PO q24hr for Depression
- Oxycodone 5 mg PO q6hr PRN for Pain
Which of the following statements about this medication regimen are correct? (Select All that Apply.)
Beta-blockers like metoprolol can mask the signs of hypoglycemia
It is safe to take additional doses of Sertraline if the patient feels like their symptoms are worsening
The patient should be monitored for orthostatic hypotension
Oxycodone can be used long-term without risk of physical dependence
The combination of triazolam and oxycodone increases the risk of respiratory depression
Correct Answer : A,C,E
A. Beta-blockers like metoprolol can mask the signs of hypoglycemia: Metoprolol can blunt adrenergic symptoms such as tachycardia and tremors, which are key warning signs of hypoglycemia. This is especially concerning in diabetic patients who rely on these symptoms for early detection of low blood glucose.
B. It is safe to take additional doses of Sertraline if the patient feels like their symptoms are worsening: Sertraline, a selective serotonin reuptake inhibitor (SSRI), must be taken exactly as prescribed. Taking extra doses increases the risk of serotonin syndrome, which can be life-threatening and requires medical supervision for dosage adjustments.
C. The patient should be monitored for orthostatic hypotension: Older adults taking medications like metoprolol and triazolam are at increased risk for orthostatic hypotension due to vasodilation and CNS depression. Monitoring helps prevent falls and syncope, especially when changing positions.
D. Oxycodone can be used long-term without risk of physical dependence: Oxycodone is an opioid analgesic and carries a high risk of tolerance, physical dependence, and addiction when used long-term. Even when used appropriately, patients can develop dependence, necessitating careful monitoring.
E. The combination of triazolam and oxycodone increases the risk of respiratory depression: Both drugs are CNS depressants, and their combination can have a synergistic effect on respiratory centers in the brain. This raises the risk of severe respiratory depression, particularly in older adults or those with underlying respiratory conditions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["15.16"]
Explanation
Given time = 3:16 pm
For times between 1:00 pm and 11:59 pm, add 12 to the hour to convert to military time.
Hour in traditional time = 3
Military time hour = 3 + 12 = 15
The minutes remain the same.
Minutes = 16
Military time = 15:16
Correct Answer is A
Explanation
A. Flush the IV line with normal saline before and after administering phenytoin: Phenytoin is incompatible with dextrose and many other IV solutions. Normal saline is the only recommended diluent, and flushing before and after administration prevents precipitation and line blockage, ensuring safe delivery of the drug.
B. Flush the IV line with dextrose solution before and after giving phenytoin: Phenytoin precipitates in dextrose-containing solutions, which can result in crystal formation, risking embolism or phlebitis. Using dextrose can lead to serious IV complications and must be avoided.
C. Mix phenytoin with lactated Ringer's solution for infusion: Phenytoin is not compatible with lactated Ringer’s due to the calcium content, which increases the risk of precipitation. It should only be diluted in normal saline to maintain solution stability and patient safety.
D. Administer phenytoin without flushing the IV line: Skipping the flush increases the risk of drug incompatibility, precipitation, and reduced drug delivery. Flushing with normal saline is essential to maintain IV line patency and prevent complications.
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