What is important for the nurse to assess in the patient's history before administering a serotonin agonist?
Hypertension.
Allergy to penicillin.
Chronic bronchitis.
Cataracts.
The Correct Answer is A
Choice A rationale
Serotonin agonists, such as triptans used for migraines, cause vasoconstriction by stimulating serotonin receptors on intracranial blood vessels. This vasoconstrictive effect is a contraindication in patients with a history of hypertension, especially uncontrolled hypertension, as it can dangerously increase blood pressure and lead to a hypertensive crisis or cardiovascular event.
Choice B rationale
There is no known cross-reactivity or contraindication between serotonin agonists and penicillin allergies. These drug classes have completely different chemical structures and mechanisms of action. Penicillin is an antibiotic that interferes with bacterial cell wall synthesis, while serotonin agonists act on specific neurotransmitter receptors.
Choice C rationale
Serotonin agonists do not directly affect the bronchial smooth muscle in a way that would be contraindicated in chronic bronchitis. The primary concern with these medications is their vascular effects, not their respiratory effects. Chronic bronchitis, while a respiratory condition, is not a known contraindication for serotonin agonists unless there is an underlying cardiovascular comorbidity.
Choice D rationale
Cataracts are a condition of the eye characterized by the clouding of the lens. This condition is not related to the mechanism of action or the side effect profile of serotonin agonists. There is no known pharmacological or physiological interaction between serotonin agonists and the development or progression of cataracts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
A patient reporting an increase in suicidal ideation after starting an antidepressant requires immediate and careful assessment. Encouraging them to continue the medication without evaluation could be dangerous and goes against the principle of patient safety. The patient's report is a critical red flag that must be addressed.
Choice B rationale
The black box warning for many antidepressants highlights the risk of increased suicidal thoughts and behaviors in some patients, particularly children, adolescents, and young adults. Documenting the patient's report and notifying the healthcare provider immediately is the appropriate and safest course of action to ensure proper management.
Choice C rationale
Discontinuing an antidepressant abruptly can lead to withdrawal symptoms and rebound depression, potentially worsening the patient's condition. It is not within the nurse's scope of practice to unilaterally discontinue a prescription medication. The healthcare provider must be consulted for a new treatment plan.
Choice D rationale
Increasing the dose of an antidepressant in a patient who reports increased suicidal ideation is contraindicated. This action could potentially exacerbate the side effects and the patient's symptoms, increasing the risk of self-harm. The provider must evaluate the patient's response and adjust the treatment plan accordingly.
Correct Answer is B
Explanation
Choice A rationale
Alpha-adrenergic blockers primarily affect vascular tone by blocking alpha-1 adrenergic receptors, leading to vasodilation. While severe hypotension from these agents could theoretically compromise renal perfusion, renal failure is not a common or direct adverse effect. The primary concern is related to rapid changes in blood pressure, not a direct nephrotoxic effect on the kidneys themselves.
Choice B rationale
Alpha-adrenergic blockers cause vasodilation by inhibiting the sympathetic nervous system's vasoconstrictive effects on arterioles and veins. This leads to a decrease in peripheral vascular resistance and venous return. When the patient stands up, this vasodilation prevents the normal compensatory increase in blood pressure, resulting in a sudden drop in blood pressure and cerebral perfusion, clinically manifested as orthostatic hypotension.
Choice C rationale
Alpha-adrenergic blockers do not typically cause hyperglycemia. In fact, some alpha-1 antagonists have been shown to improve insulin sensitivity and glucose metabolism in patients with insulin resistance. The primary concern with this class of drugs is their effect on blood pressure, not their influence on glucose regulation, as their mechanism of action is distinct from hormonal pathways that regulate blood glucose levels.
Choice D rationale
Alpha-adrenergic blockers primarily act on the peripheral vascular system and have minimal to no direct effect on the respiratory drive centers in the brainstem. Respiratory depression is more commonly associated with central nervous system depressants, such as opioids or benzodiazepines, which act on different receptor systems. Therefore, this adverse effect is not a typical concern with alpha-adrenergic blocker administration.
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