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?

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

Remind the client to drink plenty of fluids when taking 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 A

Choice A reason: Zolpidem is a hypnotic drug that induces sleep by enhancing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits brain activity. Zolpidem is used to treat insomnia, or difficulty falling asleep or staying asleep. Zolpidem should be taken only at bedtime, when the client is ready to go to sleep and can devote at least seven to eight hours for uninterrupted sleep. Taking zolpidem during the day can cause excessive sedation, drowsiness, confusion, memory loss, and impaired coordination. Therefore, the nurse should encourage the client to wait until bedtime to take the medication and avoid daytime naps.

Choice B reason: Reminding the client to drink plenty of fluids when taking the medication is not an action that the nurse should take in this situation, but rather a general recommendation that applies to most medications. Drinking fluids can help to prevent dehydration, flush out toxins, and maintain kidney function. However, drinking fluids is not specific to zolpidem and does not affect its absorption or metabolism.

Choice C reason: Advising the client to take the medication with the noon meal is not an action that the nurse should take in this situation, but rather a harmful suggestion that can reduce the effectiveness of zolpidem and increase its side effects. Taking zolpidem with food can delay its onset of action and make it less potent. Taking zolpidem at noon can also interfere with the client's circadian rhythm, or natural sleep-wake cycle, and cause daytime sleepiness and nighttime insomnia.

Choice D reason: Explaining that the client needs to allow for sleep time of at least two hours is not an action that the nurse should take in this situation, but rather an inaccurate and insufficient information that can mislead the client and endanger their safety. Zolpidem has a half-life of about two hours, which means that half of its dose is eliminated from the body in two hours. However, this does not mean that its effects wear off in two hours. Zolpidem can still cause residual sedation and impairment for several hours after taking it. The client needs to allow for sleep time of at least seven to eight hours when taking zolpidem, not just two hours.

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Correct Answer is C

Explanation

Choice A reason: Replacing leafy vegetables with a protein source is not necessary or advisable for a vegetarian client who takes warfarin. Leafy vegetables are rich in vitamin K, which can interfere with warfarin's anticoagulant effect, but they also provide other nutrients and benefits for health. Protein sources such as nuts or beans may also contain vitamin K or other substances that can affect warfarin's action.

Choice B reason: Commending the client for her healthy lifestyle and encouraging her to continue her current diet habits is not appropriate or safe for a vegetarian client who takes warfarin. Leafy vegetables can alter warfarin's anticoagulant effect and increase the risk of bleeding or clotting complications if not monitored closely by the healthcare provider.

Choice C reason: Advising the client that the healthcare provider needs to be made aware of her current diet is the best response for a vegetarian client who takes warfarin. Leafy vegetables can affect warfarin's anticoagulant effect by increasing vitamin K levels in the body, which counteracts warfarin's action. The healthcare provider can adjust the warfarin dose accordingly and monitor the client's international normalized ratio (INR), which is a measure of blood clotting time.

Choice D reason: Confirming that her diet choices will help the medication be more effective in preventing blood clots is incorrect and misleading for a vegetarian client who takes warfarin. Leafy vegetables can decrease warfarin's anticoagulant effect by increasing vitamin K levels in the body, which enhances blood clotting. This can reduce the effectiveness of warfarin and increase the risk of thromboembolic events, such as stroke or pulmonary embolism.

A. Apply oxygen face mask. B. Administer a narcotic reversal drug. C. Remove the morphine patches. D. Monitor blood pressure.

Correct Answer is C

Explanation

Choice B reason: Naloxone may be necessary, but first, the source of overdose (patches) must be removed to prevent further opioid absorption. After removal, the nurse should assess the severity and then administer naloxone if needed.

Choice A reason: Applying oxygen face mask is not the first action that the nurse should take in this situation, but rather a supportive measure that can be done after administering naloxone. Oxygen can help to improve the client's oxygenation and prevent hypoxia, but it will not reverse the opioid overdose.

Choice C reason: The client is exhibiting signs of opioid overdose, including respiratory depression (shortness of breath) and decreased level of consciousness (difficult to arouse). The first priority is to remove the excess morphine patches to stop further opioid absorption and prevent worsening of the overdose.

Choice D reason: Monitoring blood pressure is not the first action that the nurse should take in this situation, but rather an ongoing assessment that can be done after administering naloxone. Monitoring blood pressure can help to detect any changes in the client's hemodynamic status and guide further interventions, but it will not reverse the opioid overdose.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

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A client with benign prostatic hyperplasia receives a new prescription of tamsulosin. Which intervention should the nurse perform to monitor for an adverse reaction?

Which nursing action has the highest priority when administering a dose of codeine with acetaminophen to a client?

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

A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem?

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Prior to administering the evening dose of carbamazepine, the nurse notes that the client's morning carbamazepine level was 8.4 mg/L (35.6 mcmol/L). Which action should the nurse take?