Nokea
The client taking sertraline for treatment of depression for the past 11 months reports feeling much better and wishes to discontinue the medication. Which is the nurse's most appropriate response?
- A. The medication will have to be reduced gradually to prevent undesirable symptoms.
- B. You should not stop the medication without talking to your health care provider first.
- C. It appears that the medication has worked very well. It should be safe to discontinue its use.
- D. You should take this medication indefinitely to prevent recurrence of depressive symptoms.
Correct Answer: A
Rationale: Sertraline (Zoloft) is an SSRI antidepressant. Stopping these abruptly can cause withdrawal symptoms. The dose should be reduced gradually.
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The nurse is providing instructions to the client taking alprazolam. Which substances should the client be instructed to avoid? Select all that apply.
- A. Alcohol
- B. Caffeine
- C. Narcotics
- D. Antioxidants
- E. Antihistamines
- F. Antidepressants
Correct Answer: A,C,E,F
Rationale: Alcohol, narcotics, antihistamines, and antidepressants can increase CNS side effects when taken with alprazolam (Xanax).
The client taking rifampin brings a sample of urine that is orange in color to the clinic. Which interventions should the nurse implement? Select all that apply.
- A. Send the urine to the lab for culture and sensitivity (C&S).
- B. Reassure the client that this is normal and harmless.
- C. Teach that the urine that is orange can stain clothing.
- D. Question continuation of rifampin with the HCP.
- E. Inform that sweat and tears can also turn orange-colored.
Correct Answer: B,C,E
Rationale: A: A C&S is unnecessary because orange-colored urine is a normal finding in the client taking rifampin. B: The nurse should reassure the client that orange-colored urine is a normal finding in the client taking rifampin (Rifadin). C: The nurse should teach the client that the orange-colored urine and sweat can stain clothing and that the client should consider wearing nonwhite clothing or using undergarments if sweating is excessive. D: It is unnecessary to question continuation of rifampin if the urine is orange-colored because this is a normal finding. E: The nurse should inform the client that other body fluids, such as tears, sweat, and saliva, can also turn orange-colored with the use of rifampin (Rifadin).
The clinic nurse is teaching the parent how to give eye drops to the 3-year-old who has bacterial conjunctivitis and purulent drainage out of both eyes, swollen eyelids, and inflamed conjunctiva. What information should the nurse provide?
- A. Restrain the child prior to administering the eye drops.
- B. Have the child sitting when administering the eye drops.
- C. Place the child in a head-down position to instill the eye drops.
- D. Obtain the child's cooperation by describing the procedure in detail.
Correct Answer: A
Rationale: A: It is necessary to secure the child prior to instilling eye drops to ensure that the child receives the entire prescribed dose. The child is likely to resist instillation of the eye drops because a child is told not to put anything in the eyes and is likely to remember painful experiences such as dust or a foreign object that has gotten into the eye. B: The child should be supine, not sitting, when instilling eye drops. C: The child should be supine, not in a head-down position, when instilling eye drops. D: Telling the child what is happening is important, but at the age of 3, a detailed explanation will not make the child more cooperative.
The client is to receive a first dose of oral sulfamethoxazole 1 g every 12 hours for treatment of recurrent UTIs. Which information about the client should prompt the nurse to question the medication order?
- A. History of gastric ulcer
- B. Type 1 diabetes mellitus
- C. Urine positive for Escherichia coli
- D. Near-term pregnancy
Correct Answer: D
Rationale: A: History of gastric ulcer is not a contraindication for the use of sulfamethoxazole. B: Type 1 diabetes does not prevent the use of sulfamethoxazole. C: A positive urine culture would be an indication for using sulfamethoxazole. D: Sulfamethoxazole (Bactrim, Septra), a sulfonamide antibiotic, is a category D medication for near-term pregnancy. This means there is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., for a life-threatening illness or a serious disease for which safer medications cannot be used or are ineffective).
The nurse is reviewing information for the 6-month-old who is being given ranitidine. Which finding should the nurse identify as an adverse effect of ranitidine?
- A. A heart rate of 110 bpm
- B. Oral temperature of 102.7°F (39.3°C)
- C. Spitting up some formula after each feeding
- D. A hard, pebble-like bowel movement every 2 days
Correct Answer: D
Rationale: A: An HR of 110 bpm is normal for a 6-month-old; the range is 80-170 bpm. B: Fever (temperature of 102.7°F) is not an adverse effect of ranitidine. C: Ranitidine is indicated for GERD; spitting up after feedings should improve. If not, then the medication dose may be too low or the medication itself ineffective. Spitting up is not a side effect. D: The nurse should identify that a hard, pebble-like bowel movement every 2 days demonstrates constipation; constipation is an adverse effect of ranitidine (Zantac).