A preceptor is educating a new graduate nurse about barbiturates. The preceptor states, "Barbiturates were once widely used but are now rarely prescribed." Which follow-up statement by the preceptor best explains why barbiturates are not as commonly used today?

"Barbiturates carry a higher risk of dependence and overdose compared to other sedative-hypnotics."

"Barbiturates are more expensive than newer medications like benzodiazepines, which limits their use."

"Barbiturates have been replaced because they are less effective than over-the-counter sleep aids."

"Barbiturates are safer for long-term use compared to other sedatives, but they have limited availability."

Answer and Explanation

The Correct Answer is A

A. "Barbiturates carry a higher risk of dependence and overdose compared to other sedative-hypnotics.": Barbiturates have a narrow therapeutic index, and overdose can lead to fatal respiratory depression. Their high abuse potential and severe withdrawal symptoms make them less favorable than safer alternatives like benzodiazepines.
B. "Barbiturates are more expensive than newer medications like benzodiazepines, which limits their use.": Cost is not the primary reason for their reduced use. In fact, many barbiturates are inexpensive. Their safety profile and high risk of fatal overdose are the major concerns.
C. "Barbiturates have been replaced because they are less effective than over-the-counter sleep aids.": Barbiturates are actually very potent sedative-hypnotics. However, their risks outweigh their benefits. OTC sleep aids are less effective but considered safer for short-term use.
D. "Barbiturates are safer for long-term use compared to other sedatives, but they have limited availability.": Barbiturates are not safer for long-term use. They are associated with tolerance, dependence, cognitive impairment, and severe withdrawal, which is why their use has been largely replaced.

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Correct Answer is A

Explanation

A. "If my pain persists, I can safely increase the dose to 1500 mg every 4–6 hours.": This dose exceeds the maximum safe limit for acetaminophen. The recommended adult dose is no more than 1000 mg per dose and 4000 mg per day. Exceeding this can lead to serious hepatotoxicity, especially with prolonged use or preexisting liver conditions.
B. "I should use caution when taking acetaminophen with warfarin as it may affect my INR levels.": Acetaminophen can increase the anticoagulant effect of warfarin, possibly elevating INR and increasing the risk of bleeding. Regular monitoring is recommended when both drugs are used concurrently.
C. "I need to be cautious when taking other medications that may contain acetaminophen.": Many over-the-counter medications, such as cold and flu remedies, also contain acetaminophen. Accidental overdose can occur if this is not considered when calculating total daily intake.
D. "I should contact my healthcare provider if I experience yellowing of the skin or eyes.": Jaundice may be a sign of liver damage or failure due to acetaminophen toxicity. Early recognition of this symptom is critical for preventing serious complications.

A. The safe and toxic plasma levels of the drug are very close to each other B. The drug has a wide range between its effective dose and toxic dose C. The drug requires infrequent monitoring of serum levels D. The drug has a high margin of safety in clinical use

Correct Answer is A

Explanation

A. The safe and toxic plasma levels of the drug are very close to each other: A narrow therapeutic index means there is a small margin between the minimum effective concentration and the toxic concentration. Small dosing errors or individual variations in metabolism can lead to toxicity or subtherapeutic effects, requiring close monitoring.
B. The drug has a wide range between its effective dose and toxic dose: This describes a drug with a wide therapeutic index, which allows more flexibility in dosing without significant risk of toxicity. Narrow therapeutic index drugs are the opposite and require precise dosing.
C. The drug requires infrequent monitoring of serum levels: Medications with a narrow therapeutic index often require frequent serum level monitoring to ensure that the drug stays within the safe and effective range. This helps reduce the risk of adverse effects or treatment failure.
D. The drug has a high margin of safety in clinical use: A high margin of safety is characteristic of drugs with a wide therapeutic index. Narrow therapeutic index drugs have a low safety margin and pose higher risks if not carefully dosed and monitored.

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A preceptor is educating a new graduate nurse about barbiturates. The preceptor states, "Barbiturates were once widely used but are now rarely prescribed." Which follow-up statement by the preceptor best explains why barbiturates are not as commonly used today?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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