The nurse will instruct patients about a possible systemic effect that may occur with the use of inhaled albuterol. Which systemic effect may occur?

Drowsiness

Bradycardia

Heartburn

Palpitations

Answer and Explanation

The Correct Answer is D

Choice A reason: Drowsiness is not a systemic effect of inhaled albuterol, a beta-2 agonist. Albuterol stimulates beta-adrenergic receptors, increasing cyclic AMP, which can cause CNS stimulation, not sedation. Drowsiness is more associated with antihistamines or other CNS-depressant drugs, not bronchodilators like albuterol.

Choice B reason: Bradycardia is unlikely with albuterol, which activates beta-2 receptors and, to a lesser extent, beta-1 receptors in the heart, potentially causing tachycardia. Systemic absorption of inhaled albuterol can increase heart rate, not decrease it, as it stimulates sympathetic activity, making this incorrect.

Choice C reason: Heartburn is not a recognized systemic effect of inhaled albuterol. While gastrointestinal irritation may occur with oral beta-agonists, inhaled albuterol has minimal systemic absorption, targeting airway smooth muscle. Its side effects are primarily cardiovascular or neurological, not gastrointestinal, making this an incorrect choice.

Choice D reason: Palpitations are a possible systemic effect of inhaled albuterol due to its beta-adrenergic stimulation. Even with low systemic absorption, albuterol can stimulate cardiac beta-1 receptors, increasing heart rate and causing palpitations. This is a known side effect, particularly in sensitive patients or with overuse.

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Correct Answer is A

Explanation

Choice A reason: Theophylline, a methylxanthine, causes palpitations by increasing cyclic AMP through phosphodiesterase inhibition, stimulating cardiac beta-1 receptors. This can lead to tachycardia or arrhythmias, especially at high levels. Monitoring heart rate is critical due to theophylline’s narrow therapeutic index and potential for cardiovascular toxicity.

Choice B reason: Diarrhea is not a primary adverse effect of theophylline. Gastrointestinal upset, like nausea or vomiting, may occur due to gastric irritation, but diarrhea is less common. Theophylline’s main toxicities involve the cardiovascular and nervous systems, making palpitations a more significant concern.

Choice C reason: Drowsiness is not associated with theophylline, which acts as a CNS stimulant, potentially causing nervousness or insomnia. Its phosphodiesterase inhibition increases cyclic AMP, enhancing alertness, not sedation. Drowsiness is more linked to antihistamines, making this incorrect for theophylline monitoring.

Choice D reason: Bradycardia is not a typical theophylline effect. Theophylline stimulates the heart via beta-1 receptor activation, causing tachycardia or palpitations. Bradycardia may occur with other drugs, like beta-blockers, but theophylline’s sympathomimetic effects make palpitations a more relevant adverse effect to monitor.

A. Amoxicillin B. Clarithromycin C. Ciprofloxacin D. Doxycycline

Correct Answer is C

Explanation

Choice A reason: Amoxicillin, a penicillin antibiotic, inhibits bacterial cell wall synthesis and is commonly used for infections like otitis media. It is not associated with tendon rupture, as it lacks the mechanism affecting collagen or connective tissue. Its side effects include gastrointestinal upset and allergic reactions, not musculoskeletal issues.

Choice B reason: Clarithromycin, a macrolide antibiotic, inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit. It is used for respiratory infections but is not linked to tendon rupture. Its side effects include gastrointestinal disturbances and QT prolongation, with no known impact on tendon integrity or collagen metabolism.

Choice C reason: Ciprofloxacin, a fluoroquinolone, is associated with tendon rupture, particularly in the Achilles tendon. It may disrupt collagen synthesis and extracellular matrix integrity, increasing tendon vulnerability, especially in older adults or those on corticosteroids. This rare but serious side effect requires monitoring during therapy.

Choice D reason: Doxycycline, a tetracycline antibiotic, inhibits protein synthesis and is used for infections like acne or Lyme disease. While it can cause photosensitivity or gastrointestinal issues, it is not associated with tendon rupture. Its mechanism does not involve collagen disruption, unlike fluoroquinolones such as ciprofloxacin.

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The nurse will instruct patients about a possible systemic effect that may occur with the use of inhaled albuterol. Which systemic effect may occur?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is taking theophylline. The nurse will monitor for which adverse effects associated with the use of this medication?

Correct Answer is A

Explanation

Which of the following antibiotics is associated with a risk of tendon rupture?

Correct Answer is C

Explanation

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