A client has a new prescription for zolpidem, a hypnotic. The client tells the home health nurse that he plans to take a dose of the medication during the day because he is exhausted and needs to take a short afternoon nap prior to an evening activity in his home. Which action should the nurse take?

Remind the client to drink plenty of fluids when taking the medication.

Encourage the client to wait until bedtime to take the medication.

Advise the client to take the medication with the noon meal.

Explain that the client needs to allow for sleep time of at least two hours.

Answer and Explanation

The Correct Answer is B

A. Remind the client to drink plenty of fluids when taking the medication:

Drinking fluids with zolpidem is not a primary concern in this situation. The main issue is the timing of the medication.

When a client with a new prescription for zolpidem, a hypnotic, plans to take a dose of the medication during the day for a short afternoon nap, the nurse should take the following action:

B. Encourage the client to wait until bedtime to take the medication.

Explanation: Zolpidem is a medication primarily prescribed to help individuals with insomnia fall asleep more easily when taken at bedtime. Taking it during the day, especially for a short nap, can lead to drowsiness, impaired coordination, and reduced alertness during activities. It is not intended for daytime use or for short naps during the day. The nurse should encourage the client to take the medication as prescribed, at bedtime, to ensure safe and effective use.

C. Advise the client to take the medication with the noon meal:

Zolpidem is not typically taken with meals. Again, the primary concern is the timing of the medication.

D. Explain that the client needs to allow for sleep time of at least two hours:

While it's important to allow for sufficient sleep time after taking zolpidem to minimize the risk of impaired alertness and coordination, the client should be encouraged to take the medication at bedtime rather than during the day to ensure it works as intended.

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Correct Answer is A

Explanation

When a client with heart failure (HF) develops hyperaldosteronism and is prescribed spironolactone, the nurse should include the following instruction in the client's plan of care:

A. Limit intake of high-potassium foods.

Explanation: Spironolactone is a potassium-sparing diuretic, and one of its actions is to promote the retention of potassium by the body. Therefore, it's important to instruct the client to limit the intake of high-potassium foods to avoid hyperkalemia (high potassium levels), which can be a potential side effect of this medication. High-potassium foods include bananas, oranges, potatoes, tomatoes, and many others.

Why the other choices are not appropriate:

B. Cover your skin before going outside:

This instruction is not directly related to spironolactone or hyperaldosteronism. It may be relevant for clients taking photosensitizing medications but is not specific to this situation.

C. Monitor skin for excessive bruising:

This instruction is also not directly related to spironolactone or hyperaldosteronism. It may be relevant in other clinical contexts, but it does not address the potential side effects or management of spironolactone.

D. Replace salt with a salt substitute:

While reducing sodium intake is often recommended for clients with heart failure, replacing salt with a salt substitute containing potassium is not advisable for clients taking spironolactone. This would increase the risk of hyperkalemia.

A. Limit fluids for several days before the first dose. B. Monitor blood pressure for several hours after the first dose. C. Increase the lantus dose by 3 units the morning of the first dose. D. Hold spironolactone for 3 days. E. Lay down if the blood pressure drops quickly after the first dose.

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"}}

Explanation

Instructions Given:

Limit fluids for several days before the first dose.

Contraindicated: Limiting fluids before taking captopril is not indicated and could lead to dehydration, which may exacerbate the risk of hypotension.

Monitor blood pressure for several hours after the first dose.

Indicated: Monitoring blood pressure after the first dose of captopril is essential to detect and manage potential first-dose hypotension.

Increase the Lantus dose by 3 units the morning of the first dose.

Contraindicated: Increasing the dose of Lantus (insulin glargine) on the morning of the first dose of captopril is not appropriate and may lead to hypoglycemia. Adjustments to diabetes medications should be made under the guidance of a healthcare provider.

Hold spironolactone for 3 days.

Contraindicated: Stopping spironolactone abruptly is not recommended without proper medical guidance, as it may lead to electrolyte imbalances and other adverse effects.

Lay down if the blood pressure drops quickly after the first dose.

Indicated: If the blood pressure drops significantly after taking the first dose of captopril, it may be advisable for the client to lie down to prevent falls and injuries.

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Laboratory Test	Result	reference range
Serum Creatinine	1 mg/dl (88.4 μmol/L)	0.5-1.1 mg/dL (44-97 μmol/L)
BUN	9 mg/dl. (3.2 mmol/L)	10-20 mg/dl. (3.6-7.1 mmol/L)
Sodium	136 mEq/L (136 mmol/L)	136 to 145 mEq/L (136 to 145 mmol/L)
Potassium	6.1 mEq/L (6.1 mmol/L)	3.5 to 5 mEq/L (3.5 to 5 mmol/L)

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"}}

Explanation

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