After receiving a nebulizer treatment with albuterol, the patient states she is feeling slightly jittery and wonders if she is having a bad reaction. What is the nurse’s best response?

We will hold the treatment for 24 hours.

This is an expected side effect. Let me take your pulse.

I will notify the physician about this adverse effect.

The next scheduled nebulizer treatment will be skipped.

Answer and Explanation

The Correct Answer is B

Choice A reason: Holding albuterol treatment for 24 hours is inappropriate, as jitteriness is a common side effect of beta-2 agonists due to sympathetic stimulation. Albuterol’s benefits in relieving bronchospasm outweigh transient side effects. Discontinuing therapy could worsen asthma symptoms, and monitoring is preferred over stopping treatment.

Choice B reason: Jitteriness is an expected side effect of albuterol, a beta-2 agonist, due to its stimulation of beta-adrenergic receptors, increasing cyclic AMP and causing mild tremors or nervousness. Checking the pulse ensures no serious tachycardia, allowing the nurse to monitor and reassure the patient while continuing necessary therapy.

Choice C reason: Notifying the physician is unnecessary for jitteriness, a common and expected side effect of albuterol. It results from beta-2 receptor stimulation, not a severe adverse reaction. Monitoring vital signs, like pulse, is sufficient to assess the patient’s response without escalating to physician notification immediately.

Choice D reason: Skipping the next albuterol treatment is not warranted, as jitteriness is a transient, expected side effect due to sympathetic stimulation. Albuterol is critical for asthma management, and discontinuation could exacerbate symptoms. Monitoring and patient education about expected effects are more appropriate than altering the treatment schedule.

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Correct Answer is C

Explanation

Choice A reason: Hydroxychloroquine is not used for intestinal tapeworms, which are treated with antiparasitic drugs like praziquantel. Hydroxychloroquine inhibits lysosomal function and is used for malaria or autoimmune diseases like lupus, not helminth infections, which require drugs targeting parasitic metabolism.

Choice B reason: Lyme disease, caused by Borrelia burgdorferi, is treated with antibiotics like doxycycline, not hydroxychloroquine. Hydroxychloroquine’s antimalarial and immunomodulatory effects are irrelevant to bacterial infections like Lyme disease, which requires antimicrobial therapy to eliminate the spirochete.

Choice C reason: Hydroxychloroquine is commonly used for systemic lupus erythematosus (SLE). It modulates the immune system by inhibiting toll-like receptor signaling, reducing inflammation and autoantibody production. This makes it effective for managing SLE symptoms like joint pain or rashes, even in non-travelers, as it is not exclusively an antimalarial.

Choice D reason: Toxoplasmosis, caused by Toxoplasma gondii, is treated with pyrimethamine and sulfadiazine, not hydroxychloroquine. Hydroxychloroquine’s mechanism does not target protozoal infections like toxoplasmosis, which require drugs that inhibit folate synthesis in the parasite, making this an incorrect indication.

A. Increased risk for immunosuppression B. Increased clearance of fluticasone, decreasing risk for side effects C. Reduced clearance of fluticasone, increasing risk for side effects D. Increased risk for hypokalemia

Correct Answer is D

Explanation

Choice A reason: Immunosuppression is not significantly increased with inhaled fluticasone and hydrochlorothiazide. Fluticasone has minimal systemic absorption, limiting systemic immunosuppression. Hydrochlorothiazide, a diuretic, does not enhance immune suppression but affects electrolytes, making hypokalemia a more relevant concern in this combination.

Choice B reason: Increased clearance of fluticasone is unlikely with hydrochlorothiazide. Fluticasone is metabolized by hepatic CYP3A4, and hydrochlorothiazide does not significantly induce this enzyme. Drug interactions affecting clearance are minimal, and the primary concern is the additive effect on potassium levels, not fluticasone metabolism.

Choice C reason: Reduced clearance of fluticasone is not a known interaction with hydrochlorothiazide. Fluticasone’s low systemic absorption and hepatic metabolism are unaffected by hydrochlorothiazide, which primarily affects renal electrolyte excretion. The combination does not increase fluticasone’s systemic side effects but may exacerbate electrolyte imbalances.

Choice D reason: Hydrochlorothiazide, a thiazide diuretic, promotes potassium excretion, causing hypokalemia. Inhaled fluticasone has minimal systemic effects but may contribute to hypokalemia when combined with systemic corticosteroids. The nurse should monitor potassium levels, as the diuretic’s effect is the primary driver of this electrolyte imbalance in this scenario.

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After receiving a nebulizer treatment with albuterol, the patient states she is feeling slightly jittery and wonders if she is having a bad reaction. What is the nurse’s best response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which of these conditions?

Correct Answer is C

Explanation

Which effect would a nurse anticipate might occur in a patient receiving inhaled fluticasone who is also prescribed hydrochlorothiazide for hypertension?

Correct Answer is D

Explanation

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