After receiving Nembutal PO at bedtime, a client is wide awake all night instead of going to sleep. What kind of adverse reaction to a drug does this situation represent?
Toxic effect
Drug allergy
Idiosyncrasy
Drug tolerance
The Correct Answer is C
Choice A reason: Toxic effects involve overdose symptoms like coma; staying awake isn’t toxicity, as Nembutal’s sedative intent is reversed, not exaggerated, in this reaction.
Choice B reason: Drug allergy causes immune responses (e.g., rash); insomnia isn’t allergic, but a paradoxical effect, differing from hypersensitivity reactions entirely.
Choice C reason: Idiosyncrasy is an unexpected reaction; Nembutal, a barbiturate, should sedate, but wakefulness is an abnormal, individual response, fitting this category precisely.
Choice D reason: Tolerance reduces efficacy over time; this acute, opposite reaction to a sedative isn’t tolerance, but an immediate, unpredictable drug response.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Osteoarthritis limits mobility; it doesn’t affect kidney function directly, so nephrotoxic drug clearance remains unchanged, not warranting a dose reduction.
Choice B reason: Diet impacts metabolism slightly; low protein may spare kidneys, but it doesn’t indicate impaired clearance requiring adjustment of nephrotoxic medication.
Choice C reason: Diabetic kidney disease with hypertension impairs filtration; reduced glomerular rate necessitates lower nephrotoxic doses to prevent further renal damage.
Choice D reason: Smoking affects lungs primarily; while it may indirectly harm kidneys, it’s less definitive than diabetic nephropathy for needing a reduced dose.
Correct Answer is D
Explanation
Choice A reason: Assuming patient preference lacks evidence; without asking, this dismisses autonomy, potentially misrepresenting the patient’s comfort with spiritual interventions.
Choice B reason: Endorsing without consent is inappropriate; the patient’s lack of affiliation suggests possible rejection, and this risks imposing unwanted religious activity.
Choice C reason: Doctor’s order isn’t required; prayer is a chaplain’s role, not medical, but patient consent is still needed, making this an unnecessary step.
Choice D reason: Permission respects autonomy; without religious affiliation, the patient may decline, and consent ensures ethical care aligned with individual beliefs.
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