A nurse is caring for a client who has just begun therapy with alprazolam to treat anxiety. The nurse should monitor the client for which of the following adverse effects of this medication?

Hearing loss

Insomnia

Bradycardia

Hypertension

Answer and Explanation

The Correct Answer is B

A. Hearing loss: Alprazolam, a benzodiazepine medication, is not typically associated with hearing loss. Adverse effects related to hearing are not commonly reported with the use of alprazolam.

B. Insomnia: Insomnia, or difficulty falling or staying asleep, is a potential adverse effect of alprazolam. While benzodiazepines like alprazolam are central nervous system depressants and can cause drowsiness, paradoxical reactions such as insomnia may occur in some individuals.

C. Bradycardia: Alprazolam is not known to cause bradycardia. Instead, it may cause mild tachycardia or irregular heart rhythms as potential cardiovascular side effects.

D. Hypertension: Alprazolam is more likely to cause hypotension (low blood pressure) rather than hypertension. Hypotension is a potential adverse effect due to its central nervous system depressant effects, which can lead to relaxation of blood vessels and decreased blood pressure.

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Correct Answer is D

Explanation

A. Protamine: Protamine is used as an antidote for heparin, not for benzodiazepines.

B. Naloxone: Naloxone is an opioid antagonist used to reverse the effects of opioids, such as morphine or heroin. It does not antagonize the effects of benzodiazepines.

C. Diphenhydramine: Diphenhydramine is an antihistamine medication commonly used for allergy relief and as a sleep aid. It does not antagonize the effects of benzodiazepines.

D. Flumazenil: Flumazenil is a benzodiazepine receptor antagonist. It is used to reverse the effects of benzodiazepine overdose or to rapidly reverse the sedative effects of benzodiazepines in cases such as anesthesia recovery. Therefore, it is the correct option for antagonizing benzodiazepines.

A. "I should expect to feel better after 24 hours of starting this medication." B. "I should not take this medicine with grapefruit juice." C. "I’ll take this medicine with food." D. "I’ll take this medicine first thing in the morning."

Correct Answer is D

Explanation

Answer: D. "I’ll take this medicine first thing in the morning."

A. "I should expect to feel better after 24 hours of starting this medication."
This statement indicates a misunderstanding of the medication's pharmacodynamics. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), generally requires a minimum of 4 to 6 weeks to exhibit therapeutic effects in treating depression. Clients may initially experience side effects, such as nausea or changes in sleep patterns, before noticing any improvement in mood. It's crucial to educate clients about this timeline to manage expectations and encourage adherence to the medication regimen.

B. "I should not take this medicine with grapefruit juice."
This statement is incorrect. While grapefruit juice can affect the metabolism of many medications due to its action on cytochrome P450 enzymes, fluoxetine is not significantly impacted by grapefruit juice. Therefore, clients can consume grapefruit juice without the risk of altering the effectiveness or safety of fluoxetine. Providing accurate dietary information is essential to ensure clients feel confident in their dietary choices while on medication.

C. "I’ll take this medicine with food."
While clients may take fluoxetine with food to help minimize potential gastrointestinal upset, it is not strictly necessary. The medication can be effective whether taken with or without food. This flexibility allows clients to choose the method that works best for their individual tolerance and lifestyle, which can improve adherence and comfort.

D. "I’ll take this medicine first thing in the morning."
This is the correct understanding. Taking fluoxetine in the morning is generally recommended because the medication can cause insomnia or increased alertness in some individuals, particularly when initiated. By taking it in the morning, clients can avoid potential sleep disturbances at night, which is important for maintaining a regular sleep-wake cycle and overall well-being. Additionally, consistent timing can help improve adherence to the treatment plan.

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A nurse is caring for a client who has just begun therapy with alprazolam to treat anxiety. The nurse should monitor the client for which of the following adverse effects of this medication?

Nursing Test Bank

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Explanation

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Explanation

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