The nurse has provided information to a patient with diabetes who has been prescribed a non-selective beta-adrenergic blocker. Which statement is correct?
I may have low blood sugars.
My dosage may need adjustment if I start taking any NSAIDs.
I will need to be evaluated in a few weeks to see if my dosage is effective.
If I get dizzy, I will stop taking the medication.
The Correct Answer is A
Choice A reason: This is the correct statement. Non-selective beta-adrenergic blockers can interfere with the signs and symptoms of hypoglycemia (low blood sugar), such as tachycardia, tremors, and sweating. They can also impair the glucose metabolism and insulin secretion in the body. Therefore, patients with diabetes who take non-selective beta-adrenergic blockers need to monitor their blood glucose levels closely and adjust their insulin or oral hypoglycemic agents accordingly.
Choice B reason: This is not a correct statement. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, do not interact with non-selective beta-adrenergic blockers. However, they can reduce the effectiveness of other antihypertensive medications, such as diuretics or ACE inhibitors, by causing fluid retention and decreasing renal blood flow.
Choice C reason: This is not a correct statement. Non-selective beta-adrenergic blockers have a rapid onset of action and can lower the blood pressure within hours of administration. Therefore, patients do not need to wait for a few weeks to see if their dosage is effective. However, they may need periodic follow-up visits to monitor their blood pressure, heart rate, and other vital signs.
Choice D reason: This is not a correct statement. Dizziness is a common side effect of non-selective beta-adrenergic blockers, especially when the patient changes position or stands up quickly. This is due to the orthostatic hypotension (a drop in blood pressure when standing up) caused by the vasodilation effect of the medication. However, this does not mean that the patient should stop taking the medication, as this can cause rebound hypertension and other complications. Instead, the patient should rise slowly from a sitting or lying position, drink plenty of fluids, and report any severe or persistent dizziness to their health care provider.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is not a correct statement. LABAs stand for long-acting beta2-agonists, which are a class of medications that relax the smooth muscles of the airways and improve the airflow in patients with asthma or COPD. However, LABAs do not reduce the risk of asthma-related deaths, and may even increase it if used alone without an inhaled glucocorticoid, which is a type of anti-inflammatory medication.
Choice B reason: This is not a correct statement. LABAs cannot be used on an as-needed basis to treat symptoms, as they have a slow onset of action and a long duration of effect. LABAs are meant to be used as a maintenance therapy to prevent asthma exacerbations, not to relieve acute symptoms. For quick relief of symptoms, patients should use a short-acting beta2-agonist, such as albuterol or salbutamol.
Choice C reason: This is not a correct statement. LABAs are not safer than short-acting beta2 agonists, as they have similar side effects, such as tachycardia, tremors, and hypokalemia. LABAs also have a black box warning that they may increase the risk of asthma-related deaths if used without an inhaled glucocorticoid.
Choice D reason: This is the correct statement. LABAs should be combined with an inhaled glucocorticoid, as this combination has been shown to improve the asthma control, reduce the frequency and severity of exacerbations, and decrease the inflammation and airway hyperresponsiveness. The inhaled glucocorticoid also reduces the risk of adverse effects and mortality associated with LABAs.
Correct Answer is A
Explanation
Choice A reason: This is the correct instruction by the nurse. Nausea and vomiting are signs of digoxin toxicity, which can be life-threatening. The patient should report these symptoms to their health care provider as soon as possible and have their digoxin level checked.
Choice B reason: This is not a correct instruction by the nurse. Auditory hallucinations are not common adverse effects of digoxin. They are more likely to occur with other drugs, such as antipsychotics or opioids.
Choice C reason: This is not a correct instruction by the nurse. Decreasing the amount of high-potassium foods can increase the risk of digoxin toxicity, as potassium competes with digoxin for binding sites on the cardiac cells. The patient should maintain a normal potassium intake and avoid sudden changes in their diet.
Choice D reason: This is not a correct instruction by the nurse. Omitting the dose of digoxin if the pulse is 70 can lead to underdosing and ineffective treatment of heart failure. The patient should only omit the dose of digoxin if their pulse is below 60, as this indicates bradycardia, which is another sign of digoxin toxicity.
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