A patient is taking benzodiazepines for anxiety.
Which adverse effect should the nurse warn about?
Hypertension.
Respiratory depression.
Hyperactivity.
Increased alertness.
The Correct Answer is B
Choice A rationale
Benzodiazepines, such as diazepam, are central nervous system depressants. Their primary action is to enhance the effect of the neurotransmitter GABA, which results in sedative, anxiolytic, and muscle-relaxant properties. This mechanism of action often leads to a decrease, not an increase, in blood pressure. Therefore, hypertension is not an anticipated adverse effect.
Choice B rationale
Benzodiazepines enhance the inhibitory effects of GABA throughout the central nervous system, including the brainstem respiratory centers. This can lead to a significant dose-dependent depression of respiratory drive. This effect is particularly dangerous when these medications are combined with other CNS depressants like opioids or alcohol, leading to potentially fatal respiratory arrest.
Choice C rationale
Benzodiazepines are known to cause central nervous system depression, leading to sedation and decreased psychomotor activity. They are prescribed to treat anxiety and insomnia, and their intended effects are calming and sedating. Hyperactivity, which is an increase in activity and restlessness, is the opposite of the expected pharmacological effect and is not a typical adverse reaction.
Choice D rationale
Benzodiazepines are known to decrease alertness and cause drowsiness due to their central nervous system depressant effects. This is a common and expected side effect, especially at higher doses or with initial use. Advising a patient about decreased alertness is essential for safety, as it can impair their ability to perform tasks requiring focus.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Antithyroid drugs are used to treat hyperthyroidism, a condition characterized by excessive thyroid hormone production. Their primary mechanism is to decrease, not increase, the synthesis of thyroid hormones to bring the body's metabolic rate back to a normal range.
Choice B rationale
The primary action of antithyroid medications, such as methimazole and propylthiouracil, is to inhibit the synthesis of thyroid hormones within the thyroid gland. They achieve this by blocking key enzymatic steps involved in the production of triiodothyronine ($T_3$) and thyroxine ($T_4$).
Choice C rationale
Antithyroid drugs do not directly stimulate the release of thyroid-stimulating hormone (TSH). TSH is produced by the pituitary gland, and its release is primarily regulated by the hypothalamus's secretion of thyrotropin-releasing hormone (TRH) and a negative feedback loop from circulating thyroid hormones.
Choice D rationale
While some antithyroid treatments, like radioactive iodine, do destroy thyroid tissue, this is not the primary action of most antithyroid drugs such as methimazole and propylthiouracil. These drugs work by inhibiting hormone production, leaving the thyroid tissue itself intact.
Correct Answer is B
Explanation
Choice A rationale
Albuterol, a short-acting beta-2 adrenergic agonist, can cause a transient increase in blood glucose levels by stimulating glycogenolysis in the liver and muscles. This effect is dose-dependent and typically short-lived. However, the continuous and sustained elevation from 170 to 202 mg/dL is more characteristic of a medication with a longer-acting metabolic effect. While possible, it is not the most likely cause.
Choice B rationale
Corticosteroids, such as prednisone or methylprednisolone, significantly increase blood glucose by promoting gluconeogenesis and inhibiting glucose uptake by peripheral tissues, leading to insulin resistance. This effect is prolonged and dose-dependent, making it a very common cause of hyperglycemia in patients, especially those with pre-existing conditions like Type 1 Diabetes Mellitus, who are already susceptible to glucose dysregulation.
Choice C rationale
Antibiotics, in general, are not known to directly cause a sustained increase in blood glucose levels. Some antibiotics like fluoroquinolones can affect glucose metabolism, but they are more commonly associated with hypoglycemia, although hyperglycemia can also occur. The effect is not as pronounced or as likely as that of corticosteroids in this clinical scenario.
Choice D rationale
Proton pump inhibitors (PPIs) work by inhibiting the H+/K+ ATPase pump in gastric parietal cells, reducing stomach acid production. There is no established direct physiological mechanism by which PPIs cause a sustained increase in blood glucose levels. Their primary effect is on the gastrointestinal system, and they do not significantly impact carbohydrate metabolism in the way that corticosteroids do.
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