A client diagnosed with depression is prescribed duloxetine. Which statement made by the client would allow the nurse to assess that the medication teaching has been effective?

"I cannot stop taking my medication abruptly."

"This medication is safe with herbal supplements."

"I have to avoid aged cheese."

"I can take extra doses as needed for anxiety."

Answer and Explanation

The Correct Answer is A

Choice A reason:
Duloxetine is a medication that should not be stopped abruptly due to the risk of withdrawal symptoms. Gradual tapering is recommended to minimize these symptoms. This understanding by the client indicates effective medication teaching.

Choice B reason:
The statement about the medication being safe with herbal supplements is incorrect. Patients should consult their healthcare provider before using herbal supplements with duloxetine, as there can be interactions.

Choice C reason:
The need to avoid aged cheese is associated with monoamine oxidase inhibitors (MAOIs), not duloxetine, which is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). This statement does not reflect accurate medication teaching for duloxetine.

Choice D reason:
Taking extra doses for anxiety without consulting a healthcare provider is not recommended. Duloxetine dosing should be consistent and as prescribed by a healthcare provider. This statement suggests a misunderstanding of medication management.

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Correct Answer is A

Explanation

Choice A Reason:
A positive pregnancy test is crucial information that must be reported immediately as it has significant implications for the patient's health and treatment options. Pregnancy can impact the results of a Schilling's test, which is used to diagnose B12 deficiency anemia, as pregnancy itself can cause changes in B12 metabolism. Therefore, the healthcare provider must be informed to adjust the diagnostic approach and ensure the safety of both the mother and the developing fetus.

Choice B Reason:
While a hemoglobin level of 9.5 g/dL is below the normal range for adult females (11.6 to 15 g/dL) and a hematocrit of 32% is at the lower end of the normal range (36% to 44%)[^10^], these results are consistent with anemia but are not as immediately critical as a positive pregnancy test in the context of a Schilling's test.

Choice C Reason:
A glycosylated hemoglobin (A1c) level of 7.5% is above the normal range (4% to 5.9%), indicating poor blood sugar control over the past two to three months, which could suggest diabetes or prediabetes. However, this is not as urgent as a positive pregnancy test when considering the administration of a Schilling's test.

Choice D Reason:
A serum cholesterol level of 237 mg/dL is considered borderline high (200 to 239 mg/dL), which may increase the risk of heart disease over time. However, this does not require immediate reporting in the context of a Schilling's test for B12 deficiency anemia as compared to a positive pregnancy test.

A. Take vitamin B6 daily to prevent peripheral neuropathy. B. Your urine and tears may turn orange. C. Arrange for a hearing exam to monitor for hearing loss. D. Wear sunscreen to prevent photosensitivity reactions.

Correct Answer is A

Explanation

Choice A reason:
Isoniazid, an antitubercular medication, can cause peripheral neuropathy, a form of nerve damage characterized by numbness, tingling, or pain, particularly in the hands and feet. This side effect is due to the drug's interference with the normal metabolism of vitamin B6 (pyridoxine). Supplementation with vitamin B6 is recommended to prevent this complication. The normal daily recommended intake for vitamin B6 in adults ranges from 1.3 to 1.7 mg.

Choice B reason:
While it is true that isoniazid can cause discoloration of bodily fluids, turning urine and tears orange, this is not a harmful side effect and does not require intervention. It is, however, important to inform the client of this possibility to prevent alarm.

Choice C reason:
There is no evidence to suggest that routine hearing exams are necessary for clients taking isoniazid unless they have pre-existing hearing conditions or are taking other medications known to affect hearing. Therefore, this is not a standard part of the teaching plan for clients on isoniazid.

Choice D reason:
Photosensitivity reactions are not commonly associated with isoniazid use. While wearing sunscreen is generally good advice for skin protection, it is not specifically related to the administration of isoniazid and thus would not be the primary information to include in the teaching plan.

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A client diagnosed with depression is prescribed duloxetine. Which statement made by the client would allow the nurse to assess that the medication teaching has been effective?

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