Which of the following is NOT a side effect of Alprazolam?

Correct Answer: C

Rationale: Insomnia is not a common side effect of Alprazolam. Alprazolam is a benzodiazepine medication commonly used to treat anxiety and panic disorders. Common side effects of Alprazolam include dizziness, drowsiness, and lethargy. However, it is not typically associated with causing insomnia as a side effect. If a person experiences unusual symptoms while taking Alprazolam, they should consult their healthcare provider for guidance.

Correct Answer: D

Rationale: Erectile dysfunction drugs, such as Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil), are contraindicated with nitroglycerin. Both nitroglycerin and erectile dysfunction drugs can cause a sudden decrease in blood pressure when taken together, leading to a serious drop in blood pressure. This could result in dizziness, lightheadedness, fainting, and even potentially life-threatening complications like a heart attack or stroke. Therefore, it is crucial to avoid the combination of nitroglycerin with erectile dysfunction medications to prevent these adverse effects.

Correct Answer: A

Rationale: Metoclopramide, a D2 antagonist, causes acute dystonia (e.g., oculogyric crisis). Procyclidine, an anticholinergic, rapidly reverses this IV, relaxing muscles, a suitable treatment. Benzhexol (trihexyphenidyl) works orally but is slower. Levodopa and bromocriptine, dopamine agonists, treat Parkinson's, not dystonia from dopamine blockade. Risperidone worsens it. IV procyclidine's speed is critical in acute settings, restoring normal movement effectively.

Correct Answer: D

Rationale: Valproic acid is metabolized in the liver, and patients with liver disease may have impaired liver function, which can lead to reduced metabolism of the drug and potential toxicity. Therefore, a patient with a history of liver disease starting therapy with valproic acid would be a cause for concern for the nurse. Monitoring of liver function tests would be crucial in this patient population to ensure the medication is being safely metabolized.

Correct Answer: B

Rationale: Biliary secretion (e.g., rifampin) leads to fecal excretion for some drugs, while others recycle enterohepatically, prolonging action. Not all are fecal-bound-recirculation varies. Gallbladder stores bile, not metabolizes. Many drugs use bile, not rare. Recirculation reflects pharmacokinetics, affecting duration.