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 B
Explanation
A. Second-generation antihistamines have shorter half-lives and require more frequent dosing compared to first-generation antihistamines: Second-generation antihistamines typically have longer half-lives, allowing once-daily dosing. They are designed for sustained action with improved compliance and fewer side effects.
B. First-generation antihistamines block both histamine and muscarinic receptors, while second-generation antihistamines primarily block histamine receptors: First-generation agents, such as diphenhydramine, cross the blood-brain barrier and exert anticholinergic effects by blocking muscarinic receptors. Second-generation antihistamines are more selective for peripheral H1 receptors, resulting in fewer CNS and anticholinergic side effects.
C. First-generation antihistamines are less likely to cause sedation compared to second-generation antihistamines: First-generation antihistamines are more likely to cause sedation because they easily penetrate the blood-brain barrier and affect central H1 receptors, unlike second-generation agents.
D. Second-generation antihistamines cross the blood-brain barrier, causing significant central nervous system effects: These medications are designed not to cross the blood-brain barrier significantly, which is why they are much less sedating and have minimal CNS effects compared to first-generation antihistamines.
Correct Answer is ["2"]
Explanation
Desired dose = 160 mg
The medication label for Bevyxxa (betrixaban) Capsules states: 80 mg per capsule.
- Determine the number of capsules needed:
Number of capsules = Desired dose / Dose per capsule
= 160 mg / 80 mg/capsule
= 2 capsules
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