A nurse is caring for a client who takes Paroxetine to treat PTSD and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions 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: C
Rationale: A mouth guard is a practical intervention for bruxism; medication changes may not address it directly.
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The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client:
- A. To take aspirin (acetylsalicylic acid) as needed for headache
- B. Drink beverages containing alcohol in moderate amounts each evening
- C. Consult with health care providers (HCPs) before receiving immunizations
- D. That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair
Correct Answer: C
Rationale: Because antineoplastic medications lower the resistance of the body, clients must be informed not to receive immunizations without a HCP's approval. Clients also need to avoid contact with individuals who have recently received a live virus vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side effects.
The nurse is talking with a group of nursing students who are doing clinical hours on the unit. A student asks if all intramuscular (IM) drugs are absorbed the same. What factor would the floor nurse tell the students to affect absorption of the IM administration of drugs?
- A. Perfusion of blood to the subcutaneous tissue
- B. Integrity of the mucous membranes
- C. Environmental temperature
- D. Blood flow to the gastrointestinal tract
Correct Answer: C
Rationale: A cold environmental temperature can cause blood vessels to vasoconstrict and decreases absorption or in a hot environment vasodilate and increase absorption of IM medications. Blood flow to the subcutaneous tissues interferes with subcutaneous injection and blood flow to the gastrointestinal (GI) tract causes alterations in absorption for oral medications. The condition of mucous membranes can interfere with sublingual (under the tongue) and buccal (in the cheek) administration of drugs.
A low-carbohydrate, high-protein diet may:
- A. Increase drug-metabolizing enzymes
- B. Decrease drug absorption from the GI tract
- C. Alter drug binding to plasma proteins
- D. Enhance drug elimination
Correct Answer: A
Rationale: High-protein diets can induce hepatic enzymes (e.g., CYP450), increasing drug metabolism.
A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should anticipate administering which of the following medications?
- A. Phenytoin
- B. Ethosuximide
- C. Gabapentin
- D. Carbamazepine
Correct Answer: B
Rationale: Ethosuximide , valproic acid , and lamotrigine are effective for absence seizures.
A nurse is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the nurse plan to take?
- A. Administer IM Enoxaparin along with the Alteplase dose.
- B. Hold direct pressure on puncture sites for up to 30 min.
- C. Administer Aminocaproic acid IV prior to alteplase infusion.
- D. Prepare to administer Alteplase within 8 hr of manifestation onset.
Correct Answer: B
Rationale: Holding pressure prevents bleeding at puncture sites after alteplase, a thrombolytic.