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 A
Explanation
A. "All antipsychotic drugs carry an equal risk of causing movement-related side effects.": First-generation antipsychotics like Haloperidol are more likely to cause extrapyramidal symptoms due to their potent dopamine D2 receptor blockade. Second-generation antipsychotics carry a lower risk, making this statement inconsistent with clinical evidence.
B. "These side effects happen because this drug blocks dopamine in certain parts of my brain.": Extrapyramidal symptoms are primarily due to dopamine blockade in the nigrostriatal pathway, which regulates motor control. Interference in this region leads to tremors, rigidity, and other movement disorders.
C. "Taking other drugs with my Haloperidol can increase the risk of extrapyramidal symptoms.": Concurrent use of medications that also affect dopamine pathways or have sedative effects can increase the likelihood of developing EPS. Drug interactions are a significant factor in overall risk.
D. "Tardive dyskinesia occurs with prolonged use of an antipsychotic drug.": Long-term use of dopamine-blocking agents, especially at high doses, can lead to tardive dyskinesia. This condition involves involuntary movements and may be irreversible, particularly in older adults.
Correct Answer is D
Explanation
A. Advise the parent to discontinue the medication immediately: Discontinuing the medication without consulting the healthcare provider is unsafe. Stimulants are effective in managing ADHD symptoms, and any adjustments should be made under medical supervision. Abrupt cessation may lead to a return or worsening of symptoms.
B. Encourage the parent to eliminate all snacks between meals to promote hunger at mealtimes: While reducing snacks may improve appetite, it can also result in missed opportunities for nutrient intake, especially when the child already has a reduced appetite due to the medication. This intervention is not the most appropriate or immediate.
C. Encourage the parent to increase the child's physical activity to stimulate appetite: Physical activity can naturally increase appetite over time, but it is not the most direct or effective strategy for managing stimulant-induced appetite suppression. This approach is more of a long-term supportive strategy.
D. Encourage the parent to make breakfast the most important meal of the day before administering the medication: Stimulant medications commonly reduce appetite, especially later in the day. Ensuring the child eats a nutritious breakfast before taking the medication helps maximize calorie and nutrient intake when appetite is highest. This is the most appropriate initial nursing intervention.
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