MACE Medical Reactions or Conditions 2 — Questions and Answers
Question 1: A resident taking metformin for type 2 diabetes develops nausea, vomiting, and muscle pain. Which serious condition should the medication aide report immediately?
- Lactic acidosis (Correct answer)
- Hypoglycemia
- Diabetic ketoacidosis
- Hyperglycemic crisis
Correct answer: Lactic acidosis
Lactic acidosis is a rare but life-threatening adverse effect of metformin, characterized by nausea, vomiting, and myalgia.
Question 2: Which symptom is MOST characteristic of an anticholinergic reaction to medication?
- Dry mouth, urinary retention, and flushed skin (Correct answer)
- Excessive salivation and bradycardia
- Diarrhea and abdominal cramping
- Pinpoint pupils and respiratory depression
Correct answer: Dry mouth, urinary retention, and flushed skin
Anticholinergic effects include dry mouth, urinary retention, flushed skin, tachycardia, and blurred vision due to blockade of muscarinic receptors.
Question 3: A resident on warfarin reports blood in the urine and prolonged bleeding from a small cut. What type of reaction is occurring?
- Toxic/overdose reaction (Correct answer)
- Allergic reaction
- Idiosyncratic reaction
- Drug-drug interaction
Correct answer: Toxic/overdose reaction
Hematuria and prolonged bleeding in a patient on warfarin indicate excessive anticoagulation, a toxic reaction from the drug's pharmacologic action.
Question 4: Which condition is indicated by a resident's complaint of severe headache, stiff neck, and sensitivity to light after starting a new antibiotic?
- Meningitis must be ruled out immediately (Correct answer)
- Tension headache from stress
- Migraine aura
- Normal drug side effect requiring no action
Correct answer: Meningitis must be ruled out immediately
Severe headache, nuchal rigidity, and photophobia are classic signs of meningitis, which is a medical emergency requiring immediate reporting.
Question 5: A resident receiving an NSAID for arthritis develops black, tarry stools. The medication aide should recognize this as a sign of:
- Gastrointestinal bleeding (Correct answer)
- Iron deficiency anemia
- Normal bowel movement variation
- Constipation from the medication
Correct answer: Gastrointestinal bleeding
Black, tarry stools (melena) indicate upper gastrointestinal bleeding, a known adverse effect of NSAIDs due to gastric mucosal irritation.
Question 6: Which skin reaction to a medication requires the medication aide to withhold the drug and report IMMEDIATELY due to risk of severe progression?
- Widespread blistering rash with mucosal involvement (Correct answer)
- Mild redness at the injection site
- Mild itching without visible rash
- Small raised hives on the forearm only
Correct answer: Widespread blistering rash with mucosal involvement
Widespread blistering with mucosal involvement may indicate Stevens-Johnson syndrome, a life-threatening skin reaction requiring emergency intervention.
Question 7: A resident on a diuretic develops muscle cramps, weakness, and irregular heartbeat. Which electrolyte imbalance is most likely?
- Hypokalemia (Correct answer)
- Hypernatremia
- Hypercalcemia
- Hypermagnesemia
Correct answer: Hypokalemia
Diuretics, especially loop and thiazide types, cause potassium loss (hypokalemia), presenting as muscle cramps, weakness, and cardiac arrhythmias.
MACE Medical Reactions or Conditions 2
A resident taking metformin for type 2 diabetes develops nausea, vomiting, and muscle pain.
Which serious condition should the medication aide report immediately?