A severely injured client has been receiving morphine sulfate IM for pain for several weeks since his automobile accident.
His physician has recently increased the dosage to be administered every 4 hours. You recognize this as an example of:
Tolerance.
Adverse reaction.
Idiosyncrasy.
Polypharmacy.
The Correct Answer is A
Choice A rationale
Tolerance is a physiological adaptation to a drug, characterized by a decreased response to the same dose, or a need for increased doses to achieve the same effect. In this case, the increased dosage of morphine over several weeks indicates that the client's body has adapted to the drug's effects, requiring more to manage pain.
Choice B rationale
An adverse reaction is an undesirable and unintended effect of a drug, occurring at normal doses. While an increased dosage might lead to adverse effects, the described scenario specifically highlights the need for a higher dose to maintain efficacy, which is characteristic of tolerance, not simply an adverse reaction.
Choice C rationale
Idiosyncrasy refers to an unpredictable, uncharacteristic, or exaggerated response to a drug that is not an allergic reaction. It is typically a genetically determined abnormal response that occurs with initial exposure or after a few doses, unlike tolerance which develops over time with repeated exposure.
Choice D rationale
Polypharmacy refers to the concurrent use of multiple medications by a patient, often more than medically necessary. While the client is receiving medication, the scenario specifically describes a change in dosage of a single medication due to a diminished response, which is characteristic of tolerance, not polypharmacy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
The upper, outer quadrant is indeed a significant portion of the breast tissue, but its size alone does not explain its importance in breast examination. The distribution of glandular tissue throughout all quadrants contributes to breast volume, but density varies.
Choice B rationale
The upper outer quadrant is the most common location for breast tumors because it contains the largest amount of glandular tissue. This anatomical concentration increases the probability of abnormal cell proliferation, leading to a higher incidence of cancerous lesions in this area.
Choice C rationale
While any breast quadrant can experience injury or calcifications, the upper outer quadrant is not inherently more prone. Calcifications often result from benign processes or can be associated with malignancy, but their predisposition isn't quadrant-specific based on injury.
Choice D rationale
Suspensory ligaments (Cooper's ligaments) are fibrous tissues providing breast support and attach throughout the breast tissue to the underlying fascia and overlying skin. Their attachment is not concentrated solely in the upper outer quadrant, but rather distributed across the entire breast.
Correct Answer is C
Explanation
Choice A rationale
Albuterol is a selective beta-2 adrenergic agonist. Its primary action is bronchodilation by stimulating beta-2 receptors in the bronchial smooth muscle, leading to relaxation and widening of the airways. It does not directly suppress the cough reflex, which is a protective mechanism to clear airways. Cough suppression is typically achieved by antitussive medications acting on the central nervous system or peripheral cough receptors.
Choice B rationale
Albuterol is a short-acting beta-agonist (SABA), characterized by a rapid onset of action and relatively short duration (4-6 hours). Therefore, it is used for immediate relief of bronchospasm and acute symptoms of asthma, not for long-term daily maintenance. Long-term maintenance medications include inhaled corticosteroids or long-acting beta-agonists (LABAs) used consistently to control inflammation and prevent exacerbations.
Choice C rationale
Albuterol's rapid onset of action and potent bronchodilatory effects make it the ideal medication for acute relief of bronchospasm in asthma. It is used as a "rescue" inhaler to quickly open airways during an asthma attack or before exercise to prevent exercise-induced bronchospasm. This immediate effect is crucial for alleviating respiratory distress.
Choice D rationale
Post-tussive emesis, or vomiting after coughing, is often a symptom of severe coughing spells. While albuterol can alleviate coughing by reducing bronchospasm, its primary mechanism is not to prevent emesis directly. Emesis is a gastrointestinal reflex; albuterol's action is primarily on the respiratory system. Addressing the underlying cause of severe coughing would indirectly reduce emesis.
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