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A nurse is caring for a client who started taking amitriptyline 6 days ago. The client reports that the medication is not helping. Which of the following responses should the nurse make?
- A. I will inform your provider so they can prescribe a different medication.
- B. You will need to take this medication on an empty stomach for it to be more effective.
- C. You will need to wait a couple of weeks to feel the therapeutic effect of the medication.
- D. I will ask your provider to increase the dose of the medication.
Correct Answer: C
Rationale: The correct response is C: "You will need to wait a couple of weeks to feel the therapeutic effect of the medication." Amitriptyline, a tricyclic antidepressant, often takes 2-4 weeks to reach its full therapeutic effect. This is due to the time required for the medication to build up in the body and for the brain chemistry to adjust. It is crucial for the nurse to educate the client about this delayed onset of action to manage their expectations and prevent premature discontinuation.
Choices A, B, and D are incorrect because they do not address the pharmacokinetics or expected timeline for amitriptyline to take effect. Informing the provider for a different medication, taking on an empty stomach, or increasing the dose may not be necessary or safe without giving the current medication adequate time to work. The nurse should prioritize patient education on the medication's expected timeline rather than making immediate changes.
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A nurse is caring for a client who is postoperative. For which of the following findings should the nurse administer ondansetron?
- A. Client reports nausea.
- B. Client reports incisional pain.
- C. Client's respiratory rate is 14/min.
- D. Client's blood pressure is 110/72 mm Hg.
Correct Answer: A
Rationale: The correct answer is A. Ondansetron is commonly used to treat nausea and vomiting, especially in postoperative clients. Administering ondansetron for nausea can help alleviate the client's discomfort and prevent further complications. Choices B, C, and D do not indicate a need for ondansetron as they are not directly related to nausea. Choice B suggests a need for pain management, choice C indicates normal respiratory rate, and choice D shows a stable blood pressure. Therefore, administering ondansetron would not be appropriate for these findings.
A nurse in a provider's office is reviewing the laboratory findings of client who has been taking gemfibrozil for 3 months. Which of the following findings should the nurse expect?
- A. Increased serum creatinine
- B. Reduced serum calcium
- C. Increased Hgb
- D. Reduced triglycerides
Correct Answer: D
Rationale: The correct answer is D: Reduced triglycerides. Gemfibrozil is a lipid-lowering medication that works by decreasing triglyceride levels. The nurse should expect a reduction in triglycerides as a therapeutic effect of the medication. Option A (Increased serum creatinine) is incorrect as gemfibrozil typically does not affect creatinine levels. Option B (Reduced serum calcium) is incorrect as gemfibrozil does not impact calcium levels. Option C (Increased Hgb) is incorrect as gemfibrozil does not directly affect hemoglobin levels. Therefore, the nurse should anticipate a decrease in triglyceride levels as the expected finding in a client taking gemfibrozil.
A nurse is caring for a client who has been taking epoetin alfa for 3 months. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication?
- A. Hgb
- B. Troponin
- C. Thyroxine (T4)
- D. Aspartate aminotransferase (AST)
Correct Answer: A
Rationale: The correct answer is A: Hgb. Epoetin alfa is a medication used to treat anemia by stimulating red blood cell production. Monitoring the client's hemoglobin (Hgb) levels is crucial to assess the effectiveness of the medication in increasing red blood cell count. Hemoglobin reflects the oxygen-carrying capacity of the blood and directly correlates with red blood cell levels. Troponin (B), Thyroxine (T4) (C), and Aspartate aminotransferase (AST) (D) are not relevant in monitoring the effectiveness of epoetin alfa therapy as they are related to cardiac function, thyroid function, and liver function, respectively.
A nurse is reinforcing teaching with a client who has pancreatitis and a new prescription for pancrelipase. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will take this medication whole.
- B. I can expect this medication to cure the pancreatitis.
- C. I should discontinue the medication if I develop fatty stools.
- D. I will take this medication at bedtime.
Correct Answer: A
Rationale: The correct answer is A: "I will take this medication whole." This is correct because pancrelipase should be taken whole to ensure the proper release of enzymes in the small intestine for digestion. Option B is incorrect because pancrelipase does not cure pancreatitis but helps with digestion. Option C is incorrect because fatty stools are expected side effects of pancrelipase and not a reason to discontinue the medication. Option D is incorrect because pancrelipase should be taken with meals or snacks, not specifically at bedtime.
A nurse is collecting data from a client who is taking ferrous sulfate. The nurse should report which of the following findings as an adverse effect of this medication?
- A. Tinnitus
- B. Hot flashes
- C. Diplopia
- D. Epigastric pain
Correct Answer: D
Rationale: The correct answer is D: Epigastric pain. Ferrous sulfate is an iron supplement commonly known to cause gastrointestinal side effects, such as epigastric pain, nausea, and constipation. The rationale behind this is that iron can irritate the stomach lining, leading to discomfort or pain in the epigastric region. Tinnitus (A), hot flashes (B), and diplopia (C) are not typically associated with ferrous sulfate administration. Tinnitus is more commonly linked to aspirin toxicity, hot flashes are often related to hormonal changes, and diplopia is a symptom of various neurological conditions. Thus, the nurse should report epigastric pain as a potential adverse effect of ferrous sulfate.