A client calls the nurse help-line and says, 'My friend and I have been swimming and drinking beer all day and he took a couple of swigs of Robitussin DM (dextromethorphan) about 15 minutes ago. Now he is acting funny and seeing things.' What should the nurse consider when formulating a response?

Correct Answer: D

Rationale: Dextromethorphan (DM), a cough suppressant, can cause dizziness, hallucinations, and confusion, especially with alcohol, which amplifies CNS depression . Dialysis isn't standard for DM overdose; it's not an opioid , though it acts centrally; and addiction isn't the acute issue. The nurse considers dizziness as a key adverse effect, worsened by beer, guiding a response to seek medical help.

Correct Answer: D

Rationale: Prescription-only medicines are included in Schedule IV of the Controlled Substances Act. Schedule IV controlled substances have a lower potential for abuse compared to drugs in Schedules I, II, and III. These prescription medications still require a prescription from a healthcare provider, but they have a lower potential for abuse and addiction, which allows them to be categorized in Schedule IV. Examples of Schedule IV substances include certain tranquilizers and sedatives like Xanax and Valium.

Correct Answer: A

Rationale: Paradoxial bronchospasm is a potential side effect of Albuterol, a common bronchodilator medication used for treating asthma and other respiratory conditions. This side effect involves a sudden narrowing of the airways, making it difficult to breathe. It is important for healthcare providers to monitor patients closely for this adverse reaction, as it can be life-threatening and may require immediate intervention. If a patient experiences paradoxical bronchospasm after using Albuterol, they should seek medical attention promptly.

Correct Answer: A

Rationale: Aspirin, an acidic drug, ionizes in the small intestine's alkaline pH, reducing absorption as ionized forms cross membranes less easily than non-ionized. Absorption increases in the stomach's acid pH. Ionization directly affects rate. It absorbs mainly in the stomach and intestine, not beyond. Decreased absorption reflects pH impact, a pharmacokinetic rule.

Correct Answer: C

Rationale: Isosorbide dinitrate, a nitrate, treats angina by dilating vessels, but its interaction with sildenafil causes severe hypotension. Both enhance cGMP, leading to profound vasodilation, a life-threatening risk. Cold extremities or hot extremities may occur as minor effects but aren't primary concerns. Tinnitus and vertigo (E) aren't linked. Given his age and potential for erectile dysfunction treatment, warning about sildenafil is critical. Nitrates' rapid action relieves rest angina, but this interaction demands patient education to prevent catastrophic blood pressure drops, distinguishing it from less severe side effects.