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 B
Explanation
Choice A reason: Lungs excrete volatile drugs like anesthetics; most medications aren’t metabolized here, as they lack the cytochrome enzymes needed for broad drug breakdown.
Choice B reason: The liver is the primary site; cytochrome P450 enzymes metabolize most drugs, converting them into active or excretable forms, critical for pharmacokinetics.
Choice C reason: Kidneys excrete metabolites; they filter, not metabolize, most drugs, relying on prior liver processing, making them secondary in the metabolic pathway.
Choice D reason: The colon absorbs some drugs but doesn’t metabolize most; its role is minimal compared to the liver’s extensive enzymatic drug transformation capacity.
Correct Answer is A
Explanation
Choice A reason: Tolerance reflects receptor desensitization or enzyme induction; higher doses compensate for reduced drug efficacy, a common pharmacological adaptation.
Choice B reason: Organ failure affects metabolism, not tolerance; tolerance is a cellular response, not solely a failure of liver or kidney drug clearance mechanisms.
Choice C reason: Stable dosing contradicts tolerance; if tolerance develops, efficacy drops, necessitating dose increases, not maintenance, to achieve therapeutic levels.
Choice D reason: Non-adherence may alter response, but tolerance occurs with consistent use; it’s a physiological adaptation, not a result of misuse or skipping doses.
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