Pharmacology Quiz 2 NU 160

Correct Answer:

A. The medication will open the airways.

D. The medication will prevent wheezing.

E. The medication will decrease coughing episodes.

Explanation of the Correct Answers:

A. The medication will open the airways.

Albuterol is a beta-2 agonist that works by relaxing the smooth muscles around the airways, leading to bronchodilation. This helps open the airways, making it easier for the person to breathe, which is why albuterol is used in the treatment of conditions like asthma and COPD.

D. The medication will prevent wheezing.

By opening the airways, albuterol can prevent wheezing, which is commonly caused by constricted or narrowed airways. Wheezing is a hallmark symptom of asthma and other respiratory conditions, and albuterol helps alleviate it by improving airflow.

E. The medication will decrease coughing episodes.

Although albuterol is primarily used to alleviate wheezing and shortness of breath by opening the airways, it can indirectly reduce coughing episodes as well. This is because coughing can often be triggered by constricted or narrowed airways, and by improving airflow, albuterol can make breathing easier, thus reducing coughing that may be associated with bronchoconstriction.

Why the Other Options Are Incorrect:

B. The medication will reduce inflammation.

Albuterol is a bronchodilator, not an anti-inflammatory drug. While it helps open up the airways, it does not directly reduce inflammation in the airways. Medications like steroids are used for that purpose, but albuterol itself does not have an anti-inflammatory effect.

C. The medication will stimulate flow of mucus.

Albuterol does not stimulate mucus production. It works by relaxing the muscles of the airways to allow for easier breathing, but it does not directly affect mucus production or clearance. Mucus flow and secretion are typically managed by other types of treatments, such as expectorants.

Summary:

Albuterol opens the airways, prevents wheezing, and can reduce coughing by improving airflow. It does not directly reduce inflammation or stimulate mucus flow. Therefore, the correct answers are A, D, and E.

Correct Answer C: Dry mouth

Explanation of the Correct Answer:

Ipratropium is an anticholinergic medication commonly used in the management of chronic obstructive pulmonary disease (COPD) and asthma. A common side effect of anticholinergic medications, including ipratropium, is dry mouth. This occurs due to the inhibition of acetylcholine, which reduces salivation. Clients should be informed that this is a typical and manageable side effect.

Why the Other Options Are Incorrect:

A. Drowsiness

Incorrect. Ipratropium is not known to cause drowsiness. It is a bronchodilator and does not have sedative effects, which makes drowsiness an uncommon side effect.

B. Muscle tremors

Incorrect. Muscle tremors are more commonly associated with medications like beta-agonists (e.g., albuterol), not ipratropium. Ipratropium does not typically cause muscle tremors.

D. Increased salivation

Incorrect. Ipratropium works by blocking acetylcholine, leading to a decrease in salivation, not an increase. Increased salivation is not a side effect of ipratropium.

Summary:

The nurse should inform the client that dry mouth is a common side effect of ipratropium and advise the client on ways to manage it, such as drinking water or using sugar-free gum or lozenges.

Correct Answer:

C. Mesalamine

E. Sulfasalazine

Explanation:

5-Aminosalicylates (5-ASAs) are a class of drugs commonly used to treat inflammatory bowel diseases (IBD) like ulcerative colitis and Crohn's disease. These drugs help to reduce inflammation in the intestines and are considered first-line therapies for managing mild to moderate IBD.

Mesalamine (also known as 5-ASA) is a primary medication in this class. It is used to reduce inflammation and treat symptoms of ulcerative colitis and other forms of IBD.

Sulfasalazine is also a 5-ASA medication. It is a prodrug that breaks down into sulfa (which has anti-inflammatory properties) and 5-ASA, which helps to reduce intestinal inflammation. Sulfasalazine is often used for ulcerative colitis and Crohn's disease.

Why the Other Options Are Incorrect:

A. Infliximab is not a 5-ASA. It is a biologic medication classified as a tumor necrosis factor (TNF) inhibitor. It works by targeting TNF-alpha, which plays a role in the inflammatory process of IBD. Infliximab is used for more moderate to severe cases of IBD, including Crohn’s disease and ulcerative colitis, but it is not a 5-ASA.

B. Adalimumab is also a TNF inhibitor and works in a similar way to infliximab. Like infliximab, it is used for moderate to severe IBD, but it is not classified as a 5-aminosalicylate.

D. Tofacitinib is a Janus kinase (JAK) inhibitor, which is used in ulcerative colitis and rheumatoid arthritis. It works by inhibiting the action of specific enzymes involved in the inflammatory process. It is not a 5-ASA.

Summary: 

The medications classified as 5-Aminosalicylates (5-ASAs) for the treatment of inflammatory bowel diseases in the provided options are Mesalamine and Sulfasalazine.

Correct Answer B: The medication will relieve muscle spasms that might occur with a fracture.

Explanation of the Correct Answer:

Cyclobenzaprine is a muscle relaxant primarily used to treat muscle spasms associated with acute musculoskeletal conditions, such as fractures. It works by acting on the central nervous system to reduce muscle tone and spasms. When a fracture occurs, muscle spasms can often result as the body reacts to injury, and cyclobenzaprine helps alleviate this discomfort.

Why the Other Options Are Incorrect:

A. Cyclobenzaprine will relieve any nausea associated with a fracture.

Incorrect. Cyclobenzaprine is not used to treat nausea. Nausea can sometimes occur with fractures due to pain or medications like opioids, but cyclobenzaprine does not address this symptom.

C. Cyclobenzaprine will reduce itching that might occur as the fracture begins to heal.

Incorrect. Itching during the healing process of a fracture is typically related to the formation of a scab or callus over the fracture site or from the immobilization (e.g., casting). Cyclobenzaprine does not have any effect on itching.

D. The medication will fight microorganisms that can cause infection at the fracture site.

Incorrect. Cyclobenzaprine does not have antibiotic properties. It does not fight infections. If infection prevention is needed, the client would require an antibiotic, not a muscle relaxant.

Summary:

Cyclobenzaprine is used to relieve muscle spasms associated with fractures or musculoskeletal injuries, making option B the correct explanation for the nurse to provide to the client.

Correct Answer C: Renal stones

Explanation of the Correct Answer:

Calcium supplements are commonly prescribed for clients with osteoporosis to support bone mineral density and reduce fracture risk. However, one of the known adverse effects of calcium supplementation—particularly in high doses or when combined with inadequate fluid intake—is the development of renal (kidney) stones. These stones typically form when there is an excess of calcium excreted into the urine (hypercalciuria), leading to crystallization and the eventual formation of calcium oxalate or calcium phosphate stones.

The hallmark symptom of renal stones is flank pain, which can be severe, sharp, and radiating toward the lower abdomen or groin, depending on the stone’s location within the urinary tract. Clients may also report associated symptoms such as hematuria, nausea, vomiting, or dysuria. This presentation should prompt the nurse to suspect nephrolithiasis as a possible complication of calcium supplementation.

Why the Other Options Are Incorrect:

A. Hepatitis

Incorrect. Hepatitis involves inflammation of the liver and is not associated with calcium supplementation. It typically presents with right upper quadrant abdominal pain, jaundice, and abnormal liver function tests, not flank pain.

B. Hip fracture

Incorrect. Hip fractures are a complication of osteoporosis itself and not a result of taking calcium. In fact, calcium supplementation is intended to help prevent fractures. Additionally, hip fractures would present with localized hip or groin pain, not flank pain.

D. Pancreatitis

Incorrect. While extremely high levels of calcium (as seen in hyperparathyroidism) can rarely trigger pancreatitis, this is not a common side effect of calcium supplements alone. Pancreatitis is characterized by epigastric pain that may radiate to the back, not flank pain, making this an unlikely explanation in this case.

Summary:

The client’s report of flank pain while taking a daily calcium supplement is most consistent with renal stones, a known adverse effect of calcium supplementation due to its potential to increase urinary calcium and promote stone formation

Correct Answer C: Isoniazid can cause tingling of the hands.

Explanation of the Correct Answer:

C. Isoniazid can cause tingling of the hands.

Isoniazid is an antibiotic used to treat tuberculosis (TB), and one of its known adverse effects is peripheral neuropathy, which causes tingling, numbness, or a "pins and needles" sensation in the hands and feet. This is a result of nerve damage, often due to the drug’s effects on vitamin B6 (pyridoxine) metabolism. Patients on isoniazid are sometimes given vitamin B6 supplements to help prevent this side effect.

Why the Other Options Are Incorrect:

A. Isoniazid can cause ringing in the ears.

Ringing in the ears, or tinnitus, is not a typical side effect of isoniazid. It is more commonly associated with ototoxic drugs, like certain antibiotics (e.g., aminoglycosides) or chemotherapy agents, but not isoniazid.

B. Isoniazid can cause pain in the joints.

While joint pain is not a common adverse effect of isoniazid, it may rarely cause arthralgia (joint pain). However, this is not one of the main or characteristic side effects of the drug.

D. Isoniazid can cause yellowing of the skin.

Yellowing of the skin (jaundice) is more often related to liver dysfunction. While isoniazid can affect liver function (causing hepatotoxicity), it typically causes elevated liver enzymes, but yellowing of the skin is not a typical presentation. Jaundice may occur in severe liver toxicity, but it’s not a direct or common adverse effect of isoniazid alone.

Summary:

The correct answer is C because tingling in the hands (peripheral neuropathy) is a known adverse effect of isoniazid. Other side effects, such as pain in the joints, tinnitus, and jaundice, are not typical for this drug, although liver toxicity (which can lead to jaundice) is a known, though less frequent, serious side effect.

Correct Answers:

A. Clients should avoid live vaccines while on immunomodulator therapy.

C. Regular follow-up visits and bloodwork are essential for monitoring health status.

E. Clients should report any signs of infection immediately, such as fever or unusual fatigue.

Explanation of the Correct Answers:

Azathioprine is an immunosuppressant often used to treat autoimmune conditions like inflammatory bowel disease (IBD) and rheumatoid arthritis, and to prevent organ transplant rejection. Because it suppresses the immune system, specific safety precautions and monitoring are essential.

A. Clients should avoid live vaccines while on immunomodulator therapy.

Correct. Live vaccines (such as MMR, varicella, and intranasal flu vaccine) can pose a serious risk of infection in immunosuppressed individuals. Clients should be instructed to avoid live vaccines unless cleared by their healthcare provider.

C. Regular follow-up visits and bloodwork are essential for monitoring health status.

Correct. Azathioprine can cause bone marrow suppression, liver toxicity, and increased infection risk. Regular CBCs and liver function tests are essential to monitor for leukopenia, anemia, or hepatotoxicity.

E. Clients should report any signs of infection immediately, such as fever or unusual fatigue.

Correct. Because azathioprine weakens the immune system, clients are at increased risk of infections. Fever, sore throat, or unexplained fatigue should be reported immediately, as they may indicate a serious infection.

Why the Other Options Are Incorrect:

B. It is safe to receive live vaccines if administered at least 30 days after starting the medication.

Incorrect. Live vaccines are generally contraindicated during immunosuppressive therapy regardless of timing, unless specifically advised by a specialist.

D. Handwashing is not necessary if the client avoids sick individuals.

Incorrect. Frequent handwashing is essential for infection prevention, especially when the immune system is compromised. Avoiding sick individuals is not a substitute for good hygiene practices.

F. Clients can discontinue their medication if they feel well after a few weeks.

Incorrect. Azathioprine must be taken consistently as prescribed. Stopping without medical guidance can lead to relapse or rejection in transplant patients. Always consult a healthcare provider before making changes.

Summary:

Correct patient teaching for azathioprine includes avoiding live vaccines, attending regular bloodwork appointments, and promptly reporting infection signs. Stopping the medication without medical advice or neglecting hygiene are unsafe practices.

Correct Answers:

B. Redness or mild pain at the injection site is a common side effect.

C. Patients should monitor for signs of infection after self-injection.

E. Adalimumab can lead to reactivation of tuberculosis.

Explanation of the Correct Answers:

B. Redness or mild pain at the injection site is a common side effect.

This is a well-known side effect of subcutaneous injections, including adalimumab. The injection can cause localized redness, mild pain, swelling, or itching at the site. This is usually temporary and resolves on its own.

C. Patients should monitor for signs of infection after self-injection.

Adalimumab, like other biologic medications, can increase the risk of infections. Because it suppresses the immune system, patients should be vigilant and monitor for symptoms such as fever, redness, or swelling at the injection site, or signs of systemic infection like chills or cough.

E. Adalimumab can lead to reactivation of tuberculosis.

Adalimumab can suppress the immune system and potentially reactivate latent tuberculosis (TB) infections. Patients are often screened for TB prior to starting adalimumab therapy to reduce the risk of reactivation.

Why the Other Options Are Incorrect:

A. The injection site should be kept moist to prevent infection.

Incorrect. The injection site should be kept clean and dry. Moisture can increase the risk of infection, and patients should follow proper cleaning techniques before administering the injection. Typically, alcohol wipes are used to clean the skin prior to injection.

D. Infections are not a concern with adalimumab treatment.

Incorrect. Infections are a significant concern with adalimumab therapy because it suppresses the immune system, increasing the risk of both local and systemic infections. This is why infection monitoring is crucial during treatment.

F. The medication should be injected into the muscle of the upper arm.

Incorrect. Adalimumab is typically administered subcutaneously, not intramuscularly. Common injection sites include the abdomen or the front of the thigh. Injecting into the muscle of the upper arm is not the recommended method.

Summary:

The true statements regarding adalimumab's side effects and self-injection technique are: redness or mild pain at the injection site is common, patients should monitor for signs of infection, and adalimumab can lead to reactivation of tuberculosis. Proper injection technique and infection monitoring are essential components of safe adalimumab use.

Correct Answer C: Administer the medications 5 minutes apart.

Explanation of the Correct Answer:

It is important to administer timolol and pilocarpine eye drops at least 5 minutes apart to ensure that one medication does not dilute or interfere with the action of the other. By waiting between administrations, you maximize the effectiveness of each medication.

Why the Other Options Are Incorrect:

A. Hold pressure on the conjunctiva sac for 2 min following application of drops.

Incorrect. While punctal occlusion is often recommended with some eye medications to reduce systemic absorption, this is more critical with medications that have significant systemic side effects (e.g., timolol). However, this is not the best choice in this scenario as per standard practice.

B. It is not necessary to remove contact lenses before administering medications.

Incorrect. Contact lenses should be removed before administering eye drops, as some medications can adhere to the lenses, causing irritation or affecting the drug's effectiveness.

D. Administer the medications by touching the tip of the dropper to the surface of the eye.

Incorrect. The dropper tip should never touch the eye or eyelashes to avoid contamination and possible infection.

Summary:

The correct teaching for the client is to administer the medications 5 minutes apart to allow each medication to be effective without interference.