When can a patient anticipate ipratropium’s onset of action?

2 to 3 minutes

20 to 30 minutes

45 to 60 minutes

5 to 15 minutes

Answer and Explanation

The Correct Answer is D

hoice A reason: Ipratropium, an inhaled anticholinergic, has an onset of 5-15 minutes, not 2-3 minutes. It blocks muscarinic receptors, relaxing airway smooth muscle, but its action is slower than short-acting beta-agonists like albuterol, making this timeframe too rapid for ipratropium’s bronchodilation.

Choice B reason: An onset of 20-30 minutes is too slow for ipratropium. While its peak effect may take longer, initial bronchodilation begins within 5-15 minutes. This timeframe aligns with long-acting agents like salmeterol, not ipratropium, which is used for quicker relief in COPD or asthma.

Choice C reason: An onset of 45-60 minutes is incorrect for ipratropium. Its anticholinergic effect, inhibiting acetylcholine-mediated bronchoconstriction, starts within 5-15 minutes, with peak effects within 1-2 hours. This longer timeframe applies to oral medications or maintenance inhalers, not ipratropium’s inhaled delivery.

Choice D reason: Ipratropium’s onset is 5-15 minutes, as it rapidly blocks muscarinic receptors in airway smooth muscle, reducing bronchoconstriction in COPD or asthma. This makes it suitable for adjunctive relief in acute settings, though slower than albuterol, aligning with its pharmacodynamic profile for inhaled administration.

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Correct Answer is ["B","E"]

Explanation

Choice A reason: Antibiotics prescribed based on culture and sensitivity reports target specific bacterial susceptibilities, minimizing resistance. Appropriate use ensures effective bacterial killing, reducing the survival of resistant mutants. This practice aligns with antimicrobial stewardship, preventing the selection pressure that drives resistance development.

Choice B reason: Prescribing antibiotics for viral infections promotes resistance, as antibiotics do not affect viruses. Unnecessary exposure allows bacteria to develop resistance mechanisms, like beta-lactamase production, reducing future antibiotic efficacy. This misuse is a major contributor to the global rise of resistant bacterial strains.

Choice C reason: Taking antibiotics and antivirals together does not inherently cause resistance. Antibiotics target bacteria, and antivirals target viruses, with no direct interaction promoting bacterial resistance. Resistance arises from inappropriate antibiotic use, not combination with antivirals, making this situation irrelevant to resistance development.

Choice D reason: Microorganisms from foreign countries may carry resistance genes, but this describes transmission, not the mechanism of resistance development. Resistance occurs due to antibiotic misuse or overuse, not solely from geographic spread, making this less directly related to the situations causing resistance.

Choice E reason: Stopping antibiotics prematurely allows surviving bacteria to develop resistance. Incomplete treatment reduces antibiotic pressure, enabling bacteria to adapt through mutations or gene transfer, like plasmid-mediated resistance. Full-course adherence ensures bacterial eradication, preventing the emergence of resistant strains, making this a critical factor.

A. Headache and nervousness B. Numbness and tingling of extremities C. Reddish-orange urine and stool D. Gastrointestinal upset E. If your partner develops these lesions, then your partner can also use the medication.

Correct Answer is B

Explanation

Choice A reason: Headache and nervousness are not significant adverse effects of antitubercular drugs like isoniazid or rifampin. These symptoms are nonspecific and less concerning than neurotoxicity. Antitubercular drugs primarily affect the liver, nerves, or blood, making neurological symptoms like numbness more critical to report.

Choice B reason: Numbness and tingling of extremities indicate peripheral neuropathy, a serious adverse effect of isoniazid, which depletes pyridoxine (vitamin B6), impairing nerve function. This requires immediate reporting to adjust therapy or add pyridoxine supplementation, preventing irreversible nerve damage while continuing effective tuberculosis treatment.

Choice C reason: Reddish-orange urine and stool are expected effects of rifampin, which is metabolized to a red-orange compound excreted in bodily fluids. This is harmless and does not require reporting unless accompanied by other symptoms like jaundice, which could indicate hepatotoxicity, a more serious concern.

Choice D reason: Gastrointestinal upset is common with antitubercular drugs like rifampin or pyrazinamide but is not typically severe enough to warrant immediate reporting unless persistent or accompanied by signs of hepatotoxicity. Numbness is a more concerning neurological effect, requiring prompt prescriber notification to prevent complications.

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When can a patient anticipate ipratropium’s onset of action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Bacterial resistance to antibiotics can occur with which situations? (Select all that apply)

Correct Answer is ["B","E"]

Explanation

The nurse is discussing adverse effects of antitubercular drugs with a patient who has active tuberculosis. Which potential adverse effect of antitubercular drug therapy should the patient report to the prescriber?

Correct Answer is B

Explanation

The nurse is educating a client about an inhaled corticosteroid. What statement will the nurse include?

The prescriber has changed the patient’s medication regimen to include montelukast to treat asthma. The nurse will emphasize which point about this medication?

When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse will discuss which food?

The nurse is counseling a woman who will be starting rifampin. The patient is currently taking oral contraceptives. Which statement is true regarding rifampin therapy for this patient?

What advantage does loratadine have compared with traditional antihistamines such as diphenhydramine?

The nurse is preparing to administer heparin intravenously (IV). Which response by the nurse would be appropriate when the patient asks when the medication will start working?

When monitoring a patient who is taking intravenous dexamethasone, the nurse will monitor for signs of which condition?

Which of the following is a first-line drug for the treatment of active tuberculosis?