1. A patient with chronic obstructive pulmonary disease

(COPD) is prescribed albuterol inhaler for bronchodilation.

The nurse instructs the patient to use the inhaler as needed,

but not more than four times a day. The nurse also teaches

the patient about the possible side effects of albuterol, such

as:

a) Hypotension and bradycardia

b) Hypertension and tachycardia*

c) Hypoglycemia and tremors

d) Hyperglycemia and drowsiness

Rationale: Albuterol is a beta-2 agonist that stimulates the

beta-2 receptors in the bronchial smooth muscle, causing

bronchodilation. It can also stimulate the beta-1 receptors

in the heart, causing increased heart rate and blood

pressure. Therefore, hypertension and tachycardia are

common side effects of albuterol.

2. A patient with type 2 diabetes mellitus is prescribed

metformin to lower blood glucose levels. The nurse

monitors the patient for signs of lactic acidosis, which is a

rare but serious complication of metformin therapy. The

nurse should notify the physician immediately if the patient

exhibits any of the following symptoms, except:

a) Nausea and vomiting

b) Abdominal pain and diarrhea

c) Muscle weakness and cramps

d) Fever and chills*

Rationale: Lactic acidosis is a condition in which lactate

accumulates in the blood, causing metabolic acidosis. It can