The client is placed on lorazepam for short-term treatment of anxiety. Which instruction by the nurse is most important with lorazepam use?
- A. Take a second tablet if your anxiety is not being adequately relieved.
- B. If lorazepam is less effective after a few weeks, notify your provider.
- C. Avoid caffeinated foods and beverages, including tea and chocolate.
- D. If you are experiencing drowsiness or dizziness, notify your provider.
Correct Answer: B
Rationale: Lorazepam (Ativan) is a benzodiazepine anxiolytic and sedative-hypnotic medication. If it is less effective after a few weeks, the client may be developing a tolerance to lorazepam, and the HCP should be notified of this.
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The nurse completes teaching with the client who will be taking daily doses of disulfiram following treatment for alcoholism. Which client statement indicates correct understanding of the safe use of disulfiram?
- A. If I take disulfiram and then drink alcohol, I will become intoxicated much more quickly.
- B. I should take disulfiram in the morning so that I will be more alert throughout the day.
- C. If I do drink any alcohol, I should skip the daily dose of disulfiram to avoid becoming ill.
- D. I should avoid extracts and cough preparations containing alcohol while taking disulfiram.
Correct Answer: D
Rationale: The client should avoid alcohol-containing substances (e.g., cough preparations, extracts) to prevent severe adverse reactions with disulfiram (Antabuse).
The nurse is discussing the prescribed atypical antipsychotic medication therapy with the client with schizophrenia. What information should the nurse include in this discussion? Select all that apply.
- A. Atypical antipsychotic medications will affect the client's hallucinations and inappropriate emotional responses.
- B. Atypical antipsychotic medications are prescribed after other medications have proven ineffective in treating symptoms.
- C. The greatest concern with taking atypical antipsychotic medications is that they produce extrapyramidal side effects.
- D. Regular laboratory appointments will need to be scheduled to monitor the client's blood glucose levels.
- E. The client may experience an increase in appetite and weight gain when taking an atypical antipsychotic medication.
Correct Answer: A,D,E
Rationale: Atypical antipsychotics target hallucinations and emotional responses, require blood glucose monitoring, and may cause increased appetite and weight gain.
An allergic reaction is classified as what type of pharmacological effect?
- A. a therapeutic effect
- B. a side effect
- C. an adverse effect
- D. an incompatibility
Correct Answer: C
Rationale: An allergic reaction is considered an adverse effect, as it is unintended and requires treatment. A side effect is also undesired but is somewhat expected, and a side effect does not require intervention.
The LPN is caring for a client taking Lipitor (Atorvastatin). Which of these statements would indicate that the client may need reinforced teaching?
- A. I take my Lipitor with a glass of milk after my breakfast.
- B. I take my Lipitor and wait 30 minutes before taking my other medications.
- C. I take my Lipitor 30 minutes after I eat something.
- D. I take my Lipitor and my other morning medications with my grapefruit juice at breakfast.
Correct Answer: D
Rationale: Grapefruit juice should be avoided when taking Lipitor. Grapefruit juice blocks the enzymes needed to breakdown the drug, which leads to excessive amounts of the drug in the body.
The LPN is about to give 100 mg Lopressor (metoprolol) to a client. Before administering the drug, he takes the patient's vitals, which are as follows: Pulse: 58, Blood Pressure: 90/62, Respirations: 18/minute. What action should the LPN take?
- A. Give the client half the prescribed dose and report the findings to the RN on duty.
- B. Give the client double the dose and report the findings to the RN on duty.
- C. Administer the drug and report the findings to the RN on duty.
- D. Hold the drug and report the findings to the RN on duty.
Correct Answer: D
Rationale: Lopressor is given to treat hypertension, and a pulse of 58 and a blood pressure of 90/62 are considered low. To prevent the client from bottoming out, the drug should be held and the findings reported to the RN, who should consult with the attending physician. LPNs should never adjust client dosing, as that is outside of their scope of practice.
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