Drugs can produce a wide variety of effects in addition to the desired pharmacological effect. Sometimes the drug dose can be adjusted so that the desired effect is achieved without producing undesired secondary reactions. Which are examples of this secondary action?

Spontaneous bleeding after taking an anticoagulant

Dizziness after starting an antihypertensive

Drowsiness after taking an antihistamine

Diarrhea after taking an antibiotic

Answer and Explanation

The Correct Answer is A

A. Spontaneous bleeding after taking an anticoagulant is a secondary action that occurs due to the anticoagulant's effect on blood clotting, which is an undesired effect when it leads to excessive bleeding.

B. Dizziness after starting an antihypertensive is a common secondary action related to the lowering of blood pressure, which can lead to hypotension and resultant dizziness.

C. Drowsiness after taking an antihistamine is a well-known secondary action, especially with first-generation antihistamines, which can cause sedation as a side effect.

D. Diarrhea after taking an antibiotic is a secondary action that can occur due to disruption of the normal gut flora, leading to gastrointestinal upset. All these examples illustrate secondary effects of medications.

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Correct Answer is A

Explanation

A. Take the drug on an empty stomach is correct because tetracycline should be taken without food for optimal absorption, ideally 1 hour before or 2 hours after meals.

B. Take the drug along with a meal is incorrect as it can reduce the absorption of tetracycline.

C. Take the drug along with milk or fruit juice is incorrect because calcium and magnesium can bind to tetracycline, decreasing its effectiveness.

D. Take the drug immediately after meals is also incorrect as food can hinder absorption, making this timing ineffective for treatment.

A. Administer vitamin K per provider's orders. B. Increase the dose of warfarin and monitor INR more frequently per provider's orders. C. Discontinue warfarin and administer a dose of heparin per provider's orders. D. Continue warfarin and monitor for any symptoms of bleeding per provider's orders.

Correct Answer is A

Explanation

A. An INR of 5.0 indicates a significantly increased risk of bleeding, and administering vitamin K is the appropriate antidote for reversing the effects of warfarin. This is a critical intervention to restore coagulation.

B. Increasing the dose of warfarin is inappropriate in this scenario because the INR is already elevated; it would further increase bleeding risk.

C. While heparin can be used for anticoagulation, it is not appropriate to administer it while the INR is dangerously high without reversing the warfarin first.

D. Continuing warfarin is unsafe at this INR level due to the high risk of bleeding; monitoring for symptoms without intervention is not adequate care.

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Drugs can produce a wide variety of effects in addition to the desired pharmacological effect. Sometimes the drug dose can be adjusted so that the desired effect is achieved without producing undesired secondary reactions. Which are examples of this secondary action?

Nursing Test Bank

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Correct Answer is A

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