A client is taking Paroxetine to treat PTSD and reports teeth grinding at night. Which interventions should the nurse implement to manage Bruxism? (Select all that apply.)
- A. Concurrent administration of buspirone.
- B. Administration of a different SSRI.
- C. Use of a mouth guard.
- D. Changing to a different class of antidepressant medication.
Correct Answer: A
Rationale: The correct interventions to manage Bruxism associated with Paroxetine use include A: Concurrent administration of buspirone. Buspirone can help alleviate the side effect of Bruxism. Additionally, C: Use of a mouth guard is recommended to prevent oral damage from teeth grinding. B: Administration of a different SSRI is not necessary since the issue is specific to Paroxetine. D: Changing to a different class of antidepressant medication may be considered in severe cases, but the initial step should be to add buspirone to address the Bruxism caused by Paroxetine.
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A healthcare professional in a provider's clinic is caring for a client who reports erectile dysfunction and requests a prescription for sildenafil. Which of the following medications currently prescribed for the client is a contraindication to taking sildenafil?
- A. Isosorbide
- B. Phenytoin
- C. Metronidazole
- D. Prednisone
Correct Answer: A
Rationale: Sildenafil is contraindicated with nitrates like isosorbide due to the risk of severe hypotension. Isosorbide is a nitrate that can potentiate the hypotensive effects of sildenafil, leading to a dangerous drop in blood pressure. Therefore, it is essential to avoid concurrent use of isosorbide and sildenafil to prevent adverse effects. Phenytoin, metronidazole, and prednisone do not have significant interactions with sildenafil and are not contraindicated when used together.
Which of the following drugs has a therapeutic effect that increases cardiac output and slows heart rate?
- A. Heparin
- B. Alprazolam
- C. Digoxin
- D. Levothyroxine
Correct Answer: C
Rationale: Digoxin is the correct answer. It is a medication known for its positive inotropic effects, which increase cardiac output, and negative chronotropic effects, which slow the heart rate. These effects are achieved by inhibiting the sodium-potassium ATPase pump in myocardial cells. Therefore, Digoxin is commonly prescribed to manage conditions like heart failure and atrial fibrillation, where enhancing cardiac output and reducing heart rate are beneficial. Choices A, B, and D are incorrect because Heparin is an anticoagulant, Alprazolam is a benzodiazepine used for anxiety disorders, and Levothyroxine is a thyroid hormone replacement drug, none of which have the specified therapeutic effects on cardiac function.
When educating a patient on taking levothyroxine, a drug used to balance thyroid activity, what should you include in their education?
- A. Don't disregard side effects and consult your healthcare professionals
- B. Take this at the same time every day
- C. Thyroid tests are necessary while taking this drug
- D. It is not recommended to take this drug if you have recently had a myocardial infarction
Correct Answer: B
Rationale: The correct answer is to take levothyroxine at the same time every day. Consistent timing helps maintain stable thyroid levels, ensuring the effectiveness of the medication. It is important to establish a routine to optimize its therapeutic benefits. Choice A is incorrect as patients should not ignore side effects but should consult healthcare professionals if they experience any. Choice C is incorrect because thyroid tests may still be necessary to monitor thyroid function while on levothyroxine. Choice D is incorrect as it is not advisable to take levothyroxine if the patient has recently had a myocardial infarction without consulting their healthcare provider.
A client has a new prescription for Folic Acid. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Expect a metallic taste in your mouth.
- C. Increase your intake of green, leafy vegetables.
- D. Avoid citrus fruits.
Correct Answer: C
Rationale: The correct answer is C: 'Increase your intake of green, leafy vegetables.' Folic acid is naturally found in green, leafy vegetables. By increasing the intake of these vegetables, the client can supplement their folic acid levels. This dietary adjustment supports the client in meeting the prescription requirements and enhances the overall health benefits of folic acid. Choices A, B, and D are incorrect because they do not directly relate to increasing folic acid intake as required by the prescription.
A client with HIV-1 infection is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication?
- A. Cardiac dysrhythmia
- B. Metabolic alkalosis
- C. Renal failure
- D. Aplastic anemia
Correct Answer: D
Rationale: Corrected Rationale: Zidovudine is associated with the development of aplastic anemia, a serious adverse effect characterized by bone marrow suppression. Regular monitoring is essential to detect this side effect early and prevent complications. Cardiac dysrhythmia, metabolic alkalosis, and renal failure are not commonly associated with zidovudine use, making them incorrect choices for adverse effects of this medication.