A client has a new prescription for diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). Which information in the client’s history is of greatest concern to the nurse in monitoring the client’s response to this medication?

Osteoarthritis.

Migraine headaches.

Chronic alcoholism.

Type 2 diabetes mellitus.

Answer and Explanation

The Correct Answer is C

Choice A Reason:

Osteoarthritis is a common condition treated with NSAIDs like diclofenac. While it is important to monitor for potential side effects, osteoarthritis itself does not pose a significant concern in the context of diclofenac use. The medication is often prescribed to manage the pain and inflammation associated with osteoarthritis.

Choice B Reason:

Migraine headaches are also treated with NSAIDs, including diclofenac. While it is essential to monitor for side effects, migraines do not present a significant concern regarding the use of diclofenac. The medication can help alleviate the pain associated with migraines.

Choice C Reason:

Chronic alcoholism is of greatest concern when prescribing diclofenac. Alcohol can increase the risk of gastrointestinal bleeding and liver damage, both of which are potential side effects of NSAIDs. Combining alcohol with diclofenac can exacerbate these risks, making it crucial for the nurse to monitor the client closely and provide appropriate guidance.

Choice D Reason:

Type 2 diabetes mellitus requires careful management, but it is not the primary concern when prescribing diclofenac. While it is important to monitor for potential interactions and side effects, diabetes itself does not significantly increase the risks associated with diclofenac use compared to chronic alcoholism.

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Correct Answer is A

Explanation

Choice A Reason:

Determining the presence of abdominal pain is crucial because long-term use of ibuprofen can lead to gastrointestinal issues, including ulcers and bleeding. Abdominal pain can be an early sign of these complications, and prompt identification is essential to prevent more severe outcomes. Monitoring for gastrointestinal symptoms is a key aspect of managing patients on chronic NSAID therapy.

Choice B Reason:

While palpating the volume of pedal pulses is important for assessing peripheral circulation, it is not directly related to the potential side effects of long-term ibuprofen use. This assessment is more relevant for conditions affecting blood flow, such as peripheral artery disease, rather than for monitoring ibuprofen-related complications.

Choice C Reason:

Evaluating ongoing sleep patterns can provide valuable information about the client’s overall well-being and pain management. However, it is not the most critical assessment in the context of long-term ibuprofen use. Sleep disturbances may be related to chronic pain but are not directly indicative of ibuprofen’s adverse effects.

Choice D Reason:

Assessing back pain using a numeric scale is essential for evaluating the effectiveness of pain management strategies. However, it does not address the potential adverse effects of long-term ibuprofen use. While pain assessment is important, monitoring for signs of gastrointestinal complications takes precedence in this scenario.

A. Initiate cardiopulmonary resuscitation (CPR). B. Prepare to assist with chest tube insertion. C. Administer a second dose of naloxone. D. Determine Glasgow Coma Scale score.

Correct Answer is C

Explanation

Choice A Reason:

Initiating cardiopulmonary resuscitation (CPR) is a critical action when a patient is in cardiac arrest or not breathing. However, in this scenario, the client is experiencing severe respiratory depression due to opioid overdose, and the first line of treatment is to administer naloxone. If the client does not respond to naloxone, then CPR may be necessary, but the immediate step is to address the opioid toxicity.

Choice B Reason:

Preparing to assist with chest tube insertion is not relevant in this context. Chest tubes are typically used to treat conditions like pneumothorax or pleural effusion. The client’s symptoms are due to opioid-induced respiratory depression, which requires naloxone administration rather than chest tube insertion.

Choice C Reason:

Administering a second dose of naloxone is the appropriate action. Naloxone is an opioid antagonist that reverses the effects of opioid overdose, including respiratory depression. Given the client’s critically low respiratory rate and oxygen saturation, a second dose of naloxone is necessary to counteract the opioid effects and restore normal breathing.

Choice D Reason:

Determining the Glasgow Coma Scale (GCS) score is useful for assessing the level of consciousness, but it does not directly address the immediate need to reverse the opioid-induced respiratory depression. The priority is to administer naloxone to improve the client’s respiratory status. Once the client is stabilized, further assessments, including the GCS score, can be conducted.

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A client has a new prescription for diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). Which information in the client’s history is of greatest concern to the nurse in monitoring the client’s response to this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chronic lower back pain has been taking ibuprofen PO twice a day for several months. Which assessment is most important for the nurse to complete?

Correct Answer is A

Explanation

The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse implement?

Correct Answer is C

Explanation

Which intervention is most important for the nurse to implement for a client with type 2 diabetes mellitus (DM) who is receiving insulin lispro?

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