A patient prescribed the benzodiazepine alprazolam for anxiety reports to the nurse that they consume alcohol heavily on weekends. Which statement made by the nurse is important education the patient should receive before beginning their new medication?
"Drinking alcohol is fine as long as you limit your drinking to one or two servings while on your medication."
"Drinking alcohol with your medication can increase its action. Best practice is to cut your dosage in half if you plan to drink”
Combining these two substances can lead severe CNS suppression which is potentially fatal. These two substances should never be mixed together.”
"Combining the two substances can have a synergistic effect. This should help greatly with your anxiety”
The Correct Answer is C
A. "Drinking alcohol is fine as long as you limit your drinking to one or two servings while on your medication.": Even small amounts of alcohol can dangerously enhance the sedative effects of alprazolam. This advice is unsafe and may place the patient at risk for respiratory depression, sedation, or overdose.
B. "Drinking alcohol with your medication can increase its action. Best practice is to cut your dosage in half if you plan to drink.": Adjusting the alprazolam dose while continuing to drink alcohol is unsafe. The interaction is unpredictable, and CNS depression can occur even at reduced doses. Dose manipulation is not a safe strategy in this context.
C. "Combining these two substances can lead to severe CNS suppression which is potentially fatal. These two substances should never be mixed together.": Both alprazolam and alcohol are central nervous system depressants. When combined, they can cause profound sedation, respiratory depression, coma, or death. Education on avoiding alcohol is critical for patient safety.
D. "Combining the two substances can have a synergistic effect. This should help greatly with your anxiety.": While the combination does enhance sedative effects, it is extremely dangerous rather than therapeutic. Misleading the patient to view the interaction as beneficial could result in life-threatening consequences.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Metabolism is affected by aging in the form of decreased kidney and liver function:In older adults, liver enzyme activity and renal clearance often decline, which can slow drug metabolism and excretion. This increases the risk of drug accumulation and toxicity, making dose adjustments and careful monitoring essential when administering new medications.
B. Bedtime of the patient:The patient’s bedtime may affect adherence or convenience but does not directly impact metabolism or excretion. Timing related to sleep is not the priority when considering age-related pharmacokinetics.
C. Time of day for administering the medication:While timing may influence therapeutic effect for some drugs, it is less critical than considering how aging affects drug metabolism and elimination. Pharmacokinetic changes take precedence in older adults.
D. Generic vs. brand name:The choice between generic and brand name may affect cost or patient preference but does not impact the body’s metabolism of the drug. Age-related organ function remains the key consideration.
Correct Answer is D
Explanation
A. By neutralizing existing stomach acid through its alkaline properties:Neutralizing existing acid is the mechanism of antacids, not H2 receptor antagonists. Cimetidine does not chemically neutralize acid; it reduces acid production.
B. By stimulating the production of bicarbonate to buffer the stomach acid:Bicarbonate secretion is a natural protective mechanism of the gastric mucosa, but cimetidine does not stimulate bicarbonate. This does not explain its acid-reducing effect.
C. By inhibiting the proton pump enzyme, preventing hydrogen ion exchange in parietal cells:Proton pump inhibitors (e.g., omeprazole) act on the H⁺/K⁺ ATPase enzyme in parietal cells. Cimetidine works through H2 receptor antagonism, not by directly inhibiting the proton pump.
D. By selectively blocking H2 receptors in the stomach which suppresses gastric acid secretion:Cimetidine binds to H2 receptors on gastric parietal cells, preventing histamine from stimulating acid production. This decreases both basal and meal-stimulated gastric acid secretion, effectively reducing GERD symptoms.
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