MACE Medical Reactions or Conditions 5 — Questions and Answers
Question 1: A resident on an opioid analgesic has a respiratory rate of 8 breaths per minute and is difficult to arouse. The medication aide should FIRST:
- Call for emergency help and stay with the resident (Correct answer)
- Administer another dose to keep the resident comfortable
- Document and monitor for 30 minutes before reporting
- Apply oxygen and wait for it to improve on its own
Correct answer: Call for emergency help and stay with the resident
A respiratory rate of 8 with unresponsiveness indicates opioid-induced respiratory depression, a life-threatening emergency requiring immediate help.
Question 2: Which finding in a resident taking digoxin for heart failure should prompt the medication aide to withhold the dose and report immediately?
- Heart rate below 60 bpm and visual disturbances (Correct answer)
- Blood pressure of 130/80 mmHg
- Mild nausea after meals
- Heart rate of 72 bpm and normal color vision
Correct answer: Heart rate below 60 bpm and visual disturbances
Bradycardia (HR <60) and yellow-green visual disturbances are classic signs of digoxin toxicity, requiring the dose to be held and the nurse notified.
Question 3: A resident develops hives, itching, and a runny nose after taking a new antibiotic but has no breathing difficulty. This reaction is BEST classified as:
- Mild allergic reaction that must be reported (Correct answer)
- Normal expected side effect requiring no action
- Anaphylaxis requiring epinephrine
- Toxic reaction from too high a dose
Correct answer: Mild allergic reaction that must be reported
Urticaria, pruritus, and rhinorrhea without respiratory compromise indicate a mild allergic reaction, which still requires reporting and medication review.
Question 4: Which condition results from abrupt discontinuation of long-term corticosteroid therapy?
- Adrenal insufficiency (adrenal crisis) (Correct answer)
- Cushing's syndrome
- Hyperglycemia only
- Increased inflammation at the site of injury
Correct answer: Adrenal insufficiency (adrenal crisis)
Abrupt steroid withdrawal suppresses adrenal function, causing adrenal insufficiency with fatigue, hypotension, and electrolyte imbalances.
Question 5: A resident on an SSRI antidepressant develops easy bruising and prolonged bleeding from minor wounds. The medication aide should:
- Report the findings to the nurse as a potential adverse effect on platelet function (Correct answer)
- Apply pressure only and continue the medication without reporting
- Conclude the resident has a new bleeding disorder unrelated to the medication
- Administer vitamin K supplements immediately
Correct answer: Report the findings to the nurse as a potential adverse effect on platelet function
SSRIs inhibit serotonin uptake in platelets, impairing platelet aggregation and increasing bleeding risk, which must be reported to the nurse.
Question 6: A resident prescribed an antihistamine for allergies becomes unusually sedated and confused. For an elderly resident, this effect is BEST described as:
- An exaggerated side effect due to age-related changes in drug metabolism (Correct answer)
- A normal therapeutic response
- A sign of drug allergy
- An idiosyncratic reaction unique to antihistamines
Correct answer: An exaggerated side effect due to age-related changes in drug metabolism
Elderly patients metabolize drugs more slowly, causing exaggerated CNS side effects such as excessive sedation and confusion with antihistamines.
Question 7: A resident being treated with an aminoglycoside antibiotic reports new ringing in the ears and difficulty hearing. The medication aide should recognize this as:
- Ototoxicity, a serious adverse effect requiring immediate reporting (Correct answer)
- A common harmless side effect of antibiotics
- A sign of ear wax buildup unrelated to the medication
- An expected temporary effect that resolves after the course ends
Correct answer: Ototoxicity, a serious adverse effect requiring immediate reporting
Tinnitus and hearing loss in a patient on aminoglycosides indicate ototoxicity, an irreversible adverse effect requiring prompt reporting and possible drug discontinuation.
MACE Medical Reactions or Conditions 5
A resident on an opioid analgesic has a respiratory rate of 8 breaths per minute and is difficult to arouse.
The medication aide should FIRST: