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The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. What information is most important for the nurse to obtain?
- A. Family history of mental illness.
- B. Weight change in the last month.
- C. Liver function laboratory results.
- D. Recent use of other antidepressants.
Correct Answer: C
Rationale: Duloxetine is metabolized by the liver, and impaired liver function can increase toxicity risk. Liver function tests (C) are critical before starting. Family history (A), weight changes (B), and other antidepressants (D) are relevant but secondary to liver safety.
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A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?
- A. Determine when the last dose was administered.
- B. Review the history for past use of recreational drugs.
- C. Ask the client to rate the current level of pain using a pain scale.
- D. Encourage the client to use diversional thoughts to manage pain.
Correct Answer: C
Rationale: Assessing the client’s pain level using a pain scale (C) is the first step to quantify pain and guide appropriate dosing. Determining the last dose (A) and reviewing drug history (B) are secondary. Diversional thoughts (D) are a non-pharmacological adjunct, not the priority.
A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client’s plan of care?
- A. Replace salt with a salt substitute.
- B. Cover your skin before going outside.
- C. Limit intake of high-potassium foods.
- D. Monitor skin for excessive bruising.
Correct Answer: C
Rationale: Spironolactone, a potassium-sparing diuretic, can cause hyperkalemia. Limiting high-potassium foods (C) prevents this risk. Salt substitutes (A) often contain potassium, worsening hyperkalemia. Sun protection (B) and bruising (D) are unrelated to spironolactone’s primary risks.
A female patient who follows a vegetarian diet has recently been prescribed warfarin. She mentions that she consumes leafy green vegetables daily. What should be the nurse’s response?
- A. Praise the patient for her healthy lifestyle and encourage her to maintain her current dietary habits.
- B. Assure the patient that her dietary choices will enhance the effectiveness of the medication in preventing blood clots.
- C. Inform the patient that her healthcare provider needs to be informed about her current diet.
- D. Recommend that the patient substitutes the leafy vegetables with a protein source like nuts or beans.
Correct Answer: C
Rationale: Leafy greens, high in vitamin K, can reduce warfarin’s anticoagulant effect. Informing the provider (C) ensures dose adjustment. Praising (A) or assuring enhanced efficacy (B) ignores the interaction. Substituting vegetables (D) is unnecessary with proper monitoring.
A client with chemotherapy-induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?
- A. Diarrhea.
- B. Unusual irritability.
- C. Nausea.
- D. Involuntary movements.
Correct Answer: D
Rationale: Involuntary movements (D), such as tardive dyskinesia, are a serious, potentially irreversible side effect of metoclopramide, requiring immediate reporting. Diarrhea (A) and irritability (B) are less severe. Nausea (C) is the treated condition, not an adverse effect.
A patient with chemotherapy-induced nausea has been prescribed metoclopramide. What adverse effect should the nurse report?
- A. Diarrhea.
- B. Unusual irritability.
- C. Nausea.
- D. Involuntary movements.
Correct Answer: D
Rationale: This question is identical to Question 5. Involuntary movements (D), such as tardive dyskinesia, are a serious metoclopramide side effect, requiring immediate reporting. Diarrhea (A) and irritability (B) are less severe. Nausea (C) is the treated condition. Note: Duplicate question; consider removing.