A patient reports becoming “immune” to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by:

Synthesis of more receptor sites in response to the medication

Decreased selectivity of receptor sites, resulting in a variety of effects

Desensitization of receptor sites by continual exposure to the drug

Antagonists produced by the body that compete with the drug for receptor sites

Answer and Explanation

The Correct Answer is C

Choice A reason: Synthesis of more receptor sites (upregulation) typically occurs with receptor antagonists, not agonists, as the body compensates for blocked receptors. This would increase drug sensitivity, not decrease effectiveness. For most medications, continuous exposure leads to desensitization, not receptor proliferation, making this choice incorrect for explaining tolerance.

Choice B reason: Decreased receptor selectivity implies a drug binding to unintended receptors, causing varied effects, not reduced efficacy. Tolerance results from receptor desensitization, not altered selectivity. This mechanism doesn’t explain the patient’s “immunity” to the drug’s therapeutic effects, making this choice scientifically inaccurate for the scenario.

Choice C reason: Desensitization occurs when continuous drug exposure reduces receptor responsiveness, leading to tolerance. For example, opioid receptors downregulate or internalize with prolonged agonist exposure, decreasing drug efficacy. This explains the patient’s perception of “immunity” as the drug’s effect diminishes over time, making this the correct choice.

Choice D reason: The body does not produce antagonists to compete with drugs for receptor sites. Tolerance arises from receptor desensitization or metabolic changes (e.g., enzyme induction), not endogenous antagonist production. This mechanism is not a recognized pharmacological process for reduced drug effectiveness, making this choice incorrect.

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Correct Answer is D

Explanation

Choice A reason: Pulse oximetry of 95% is near normal and not a major concern for beta agonist administration. Tachycardia is more critical due to cardiac stimulation, so this is incorrect.

Choice B reason: A respiratory rate of 22 is slightly elevated but acceptable in respiratory conditions. Beta agonists target airways, but tachycardia is a greater risk, making this incorrect.

Choice C reason: Blood pressure of 100/60 mm Hg is low, but beta agonists primarily affect heart rate. A pre-existing tachycardia is more concerning contraindication, so this is incorrect.

Choice D reason: A heart rate of 120 beats/min is concerning, as beta agonists increase heart rate, risking arrhythmias. This requires evaluation before administration, making it the correct concern.

A. Mealtime coverage of blood glucose B. Blood glucose control for 24 hours C. Less frequent blood glucose monitoring D. Peak effect achieved in 2 to 4 hours

Correct Answer is B

Explanation

Choice A reason: Glargine provides basal, not insulin, coverage; meal coverage. It maintains steady glucose control, so this is incorrect.

Choice B reason: Insulin glargine offers 24-hour basal glucose control, stabilizing blood sugar without peaks. This is its primary effect, making it the correct outcome.

Choice C reason: Glargine requires regular monitoring, not less frequent monitoring, to ensure control. This is incorrect for the therapeutic outcome.

Choice D reason: Glargine has no peak, unlike short-acting insulins, with effects lasting 24 hours. A 2–4 hour peak is incorrect, so incorrect.

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A patient reports becoming “immune” to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is to receive a beta agonist. Before administration of this medication, which assessment finding would most concern the nurse?

Correct Answer is D

Explanation

A patient is scheduled to start taking insulin glargine (Lantus). On the care plan, the nurse should include which of these outcomes related to the therapeutic effects of the medication?

Correct Answer is B

Explanation

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