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The client is beginning treatment with bupropion for depression. After meeting with the HCP, the client tells the nurse, “I'm also taking Zyban to help me stop smoking.†Which is the most appropriate action for the nurse?
- A. Encourage and support the client in following the smoking cessation regimen.
- B. Provide the client with the telephone number for a smoking cessation support group.
- C. Instruct the client to report any allergic-type reactions after beginning the bupropion.
- D. Inform the HCP that the client is already taking bupropion, but for smoking cessation.
Correct Answer: D
Rationale: Bupropion (Zyban) should not be used for multiple conditions simultaneously due to the risk of seizures from additive doses.
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The client is experiencing delirium from substance withdrawal. Which medication, if prescribed prn, should the nurse administer to help calm the client?
- A. Flumazenil_1.PNG
- B. Flumazenil_2.PNG
- C. Flumazenil_3.PNG
- D. Flumazenil_4.PNG
Correct Answer: D
Rationale: Lorazepam (Ativan) depresses the CNS, reducing anxiety and calming the client during withdrawal.
The 16-year-old is taking acyclovir. Which statement, if made by the adolescent, should indicate to the nurse that the medication is having the desired therapeutic effect?
- A. I am having a regular menstrual cycle now.
- B. That bad odor from my vagina is now gone.
- C. All those sores on my labia are getting better.
- D. I don't have that green vaginal discharge anymore.
Correct Answer: C
Rationale: A: A side effect of acyclovir is a change in the menstrual cycle; however, having a regular menstrual cycle is not the desired therapeutic effect. B: A bad odor from the vagina is a symptom of bacterial vaginosis or trichomoniasis vaginalis, and usually not a symptom of genital herpes simplex. C: Acyclovir (Zovirax), an antiviral medication, is indicated for the treatment of genital herpes simplex virus, shingles, or chicken pox. Labial sores are associated with genital herpes simplex. Improvement of labial sores indicates that acyclovir is having the desired therapeutic effect. D: A green vaginal discharge may be a symptom of Trichomonas, which is treated with metronidazole (Flagyl), an amebicide.
The client taking imipramine is preparing for a summer vacation. Which information should the nurse include when planning client education regarding imipramine? Select all that apply.
- A. Drink additional fluids and add extra fiber to the diet
- B. Stop imipramine if experiencing any unpleasant side effects.
- C. Avoid alcohol, which can cause an additive depressant effect.
- D. Request an “as needed†sleeping pill in the event of insomnia.
- E. Wear sunglasses, protective clothing, and sunscreen while outdoors.
Correct Answer: A,C,E
Rationale: TCAs such as imipramine (Tofranil) may cause constipation, CNS depression when combined with alcohol, and photosensitivity. Increasing fluids and fiber, avoiding alcohol, and using sun protection are appropriate.
The client has an order for a 1,000 mL bag of fluids to be infused over 8 hours. What is the correct rate?
- A. 100 mL/hr
- B. 125 mL/min
- C. 125 mL/hr
- D. 80 mL/min
Correct Answer: C
Rationale: The correct calculation is 1000 / 8 which equals 125 mL/hr.
The LPN is preparing a client for discharge and the discharge medications include phenobarbital. Which of these client statements would indicate a need for reinforced teaching about this medication?
- A. I will need to avoid eating excessive leafy greens.
- B. It's best to take this medication with food.
- C. I can't wait to get back to my nightly glass of wine.
- D. I should try to take this medication at the same time every day.
Correct Answer: C
Rationale: Phenobarbital should not be taken with alcohol as it is a barbiturate. Alcohol may increase the sedative effect.