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A nurse is collecting data from a client who has been taking diazepam several times per day but recently ran out of the medication. Which of the following findings should the nurse recognize as a manifestation of withdrawal from diazepam?
- A. Tremors
- B. Anorexia
- C. Drowsiness
- D. Hypotension
Correct Answer: A
Rationale: The correct answer is A: Tremors. Diazepam is a benzodiazepine used to treat anxiety and withdrawal symptoms. Withdrawal from diazepam can lead to physical symptoms such as tremors due to the sudden decrease in the drug's effects on the central nervous system. Tremors are a common manifestation of benzodiazepine withdrawal. Anorexia (choice B) is not typically associated with diazepam withdrawal. Drowsiness (choice C) is more likely a side effect of diazepam itself, not withdrawal. Hypotension (choice D) is not a common withdrawal symptom of diazepam.
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Nurses' Notes
0800:
Client reports frequent cough, wheezing, and tightness of chest. Bilateral breath sounds with scattered inspiratory and expiratory wheezes.
1000:
Reinforced teaching about newly prescribed medications.
Click to highlight the instructions the nurse should reinforce to the client.
- A. Take your albuterol when you are having difficulty breathing.
- B. Hold your breath for 20 seconds when taking your albuterol.
- C. Take the salmeterol 5 minutes before the albuterol when you need both medications.
- D. Take the salmeterol 2 times each day.
- E. Rinse out your mouth after taking the fluticasone.
- F. Take the fluticasone as needed for an asthma attack.
Correct Answer: A,D,E
Rationale: Sure, here is a detailed explanation for each choice:
A: Taking albuterol during difficulty breathing helps relieve symptoms promptly.
D: Salmeterol should be taken twice daily for optimal effectiveness.
E: Rinsing mouth after fluticasone reduces the risk of oral thrush.
Incorrect choices:
B: Holding breath doesn't affect albuterol efficacy.
C: Timing salmeterol before albuterol isn't necessary.
F: Fluticasone is a controller, not a rescue inhaler.
A nurse is caring for a client who has a new prescription for lorazepam. For which of the following adverse effects should the nurse monitor?
- A. Urinary retention
- B. Dizziness
- C. Decreased appetite
- D. Hypertension
Correct Answer: B
Rationale: Rationale: The correct answer is B, dizziness, because lorazepam is a benzodiazepine that can cause central nervous system depression, leading to dizziness as a common adverse effect. Urinary retention (A) is not a common side effect of lorazepam. Decreased appetite (C) is not typically associated with lorazepam use. Hypertension (D) is not a common adverse effect of lorazepam. It is important to monitor for dizziness as it can affect the client's safety and mobility.
A nurse is collecting data from a client who has been taking methimazole for 2 months for the treatment of a thyroid imbalance. Which of the following findings indicates that the medication is effective?
- A. Weight gain
- B. Decreased menstrual flow
- C. Clear breath sounds
- D. Increased libido
Correct Answer: A
Rationale: The correct answer is A: Weight gain. Methimazole is used to treat hyperthyroidism, which often causes weight loss due to increased metabolism. If the medication is effective, the client's thyroid hormone levels should normalize, leading to a potential reversal of weight loss and even weight gain. Decreased menstrual flow (B) and increased libido (D) are not direct indicators of methimazole effectiveness. Clear breath sounds (C) could indicate improved respiratory status but are not specific to thyroid function.
A nurse is reinforcing discharge teaching about sublingual nitroglycerin with a client who has angina. Which of the following statements indicates an understanding of the instructions?
- A. I understand that the medication can slow my heart rate.
- B. I am going to take the medication with food.
- C. I will take the medication every 10 minutes until the pain goes away.
- D. I should feel the effects of the medication within 5 minutes.
Correct Answer: D
Rationale: Correct Answer: D
Rationale: Nitroglycerin is a fast-acting medication used to relieve angina symptoms. Choosing option D shows understanding because nitroglycerin should provide relief within 5 minutes if the medication is effective. This rapid onset is crucial in managing acute angina attacks. Taking the medication every 10 minutes (C) could lead to overdose and severe side effects. Slow heart rate (A) is not a common side effect of nitroglycerin. Taking with food (B) may delay absorption and reduce effectiveness.
A nurse in a mental health facility is collecting data from a client taking lithium. Which of the following information should the nurse report to the provider as an indication of lithium toxicity?
- A. Dry cough
- B. Elevated blood pressure
- C. Stooped posture
- D. Slurred speech
Correct Answer: D
Rationale: The correct answer is D: Slurred speech. Lithium toxicity can manifest as neurological symptoms such as slurred speech due to its effects on the central nervous system. A dry cough (A) is not typically associated with lithium toxicity. Elevated blood pressure (B) may be a sign of other conditions but is not specific to lithium toxicity. Stooped posture (C) is more indicative of musculoskeletal issues rather than lithium toxicity. In summary, slurred speech is a key neurological symptom of lithium toxicity, making it the correct choice in this scenario.