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 D

Explanation

A) Unusual irritability: While irritability can be a side effect of metoclopramide, it is not as concerning as tardive dyskinesia. It's important to monitor and report any unusual irritability, but it's not the most critical side effect.

B) Diarrhea: Diarrhea is a common side effect of metoclopramide but is generally less concerning than tardive dyskinesia. It can often be managed with dietary adjustments or other medications.

C) Nausea: Nausea is the very symptom metoclopramide is prescribed to treat. If the client is still experiencing nausea despite taking metoclopramide, this might indicate the need for a different anti-nausea medication, but it's not the most important adverse effect to report.

D.Involutary movements: The most important adverse effect for the nurse to report when a client with chemotherapy-induced nausea is taking metoclopramide is D) Involuntary movements.

Explanation:

Metoclopramide is a medication often used to relieve nausea and vomiting, especially in cases like chemotherapy-induced nausea. However, it can have a side effect known as "tardive dyskinesia," which involves involuntary movements, typically of the face and tongue. Tardive dyskinesia is a serious and potentially irreversible side effect of metoclopramide.

In summary, involuntary movements (tardive dyskinesia) are the most critical side effect to report when a client is taking metoclopramide. This side effect needs prompt attention as it can be irreversible if not addressed.

A. Wound and blood specimens for culture and sensitivity. B. Irrigation and topical antibiotic application to wound area. C. Complete blood count and serum electrolytes. D. Monitor for signs of sodium and fluid retention

Correct Answer is A

Explanation

Before administering the first dose of a broad-spectrum antibiotic to a client with a gram-negative infection, it is most important for the nurse to implement:

A. Wound and blood specimens for culture and sensitivity.

Explanation: Collecting wound and blood specimens for culture and sensitivity is crucial before starting antibiotic therapy. This step allows healthcare providers to identify the specific pathogen causing the infection and determine its sensitivity to various antibiotics. It helps in selecting the most appropriate antibiotic and ensuring effective treatment. This is especially important in cases of gram-negative infections, as antibiotic resistance patterns can vary among different strains.

Why the other choices are not the most important at this stage:

B. Irrigation and topical antibiotic application to wound area:

While wound care is important, especially for localized infections, collecting specimens for culture and sensitivity takes precedence to determine the appropriate antibiotic treatment.

C. Complete blood count and serum electrolytes:

While monitoring blood counts and electrolytes is essential in overall client care, it may not be the most critical step before administering the first dose of an antibiotic to address a suspected infection.

D. Monitor for signs of sodium and fluid retention:

Monitoring for signs of sodium and fluid retention is important, but it is not the primary action needed before initiating antibiotic therapy for a gram-negative infection. Identifying the causative organism and selecting the appropriate antibiotic should come first to target the infection directly.

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Naxlex Comprehensive Predictor Exams

A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to repart?

Correct Answer is D

Explanation

On admission, the healthcare provider prescribes a broad spectrum antibiotic for a client with a gram-negative infection. Before administering the first dose, it is most Important for the nurse to implement which prescription?

Correct Answer is A

Explanation

The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?

While assessing a client who takes acetaminophen for chronic pain, the nurse observes that the client's skin looks yellow in color. Which action should the nurse take in response to this finding?

When administering medications to a group of clients, which client should the nurse closely monitor for development of acute kidney injury (AKI)?

The healthcare provider prescribes the antibiotic tetracycline HCI for an adult client that arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?

A female client with multiple sclerosis reports having less fatigue and improved memory since she began using the herbal supplement, ginkgo biloba. Which information is most important for the nurse to include in the teaching plan for this client?

A client receives a new prescription for montelukast. Which information should the nurse include in the client's teaching?