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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Filgrastim is a colony-stimulating factor that stimulates the bone marrow to produce more neutrophils, which are a type of white blood cell that fight infection. Filgrastim is used to treat neutropenia (low neutrophil count), which can be caused by chemotherapy, bone marrow transplant, or other conditions. The normal range of WBC is 5000 to 10,000/mm3 (5 to 10 x 109/L), and the normal range of neutrophils is 2500 to 8000/mm3 (2.5 to 8 x 109/L). Therefore, an increase in WBC from 2500/mm3 to 5000/mm3 indicates that filgrastim has been effective in increasing neutrophil production and improving the client's immune system. The nurse should inform the client that the medication has been effective and encourage them to continue taking it as prescribed.
Choice B reason: Reviewing the client's culture and sensitivity reports is not an action that the nurse should implement in this situation, but rather a routine assessment that the nurse should perform for any client with an infection. Culture and sensitivity reports identify the type and source of infection and the most effective antibiotic therapy. The nurse should review these reports to monitor the client's response to treatment and adjust the antibiotic regimen as needed.
Choice C reason: Assessing the client's vital signs is not an action that the nurse should implement in this situation, but rather a standard practice that the nurse should perform for any client. Vital signs include temperature, pulse, respiration, blood pressure, and oxygen saturation. The nurse should assess these parameters to detect any signs of infection, inflammation, or sepsis, such as fever, tachycardia, tachypnea, hypotension, or hypoxia.
Choice D reason: Implementing neutropenic precautions is not an action that the nurse should implement in this situation, but rather a preventive measure that the nurse should take for clients with severe neutropenia. Neutropenic precautions are a set of infection control practices that aim to protect clients with low neutrophil counts from exposure to pathogens. These include wearing gloves, masks, and gowns; washing hands frequently; avoiding contact with sick people or animals; and avoiding raw or undercooked foods. However, these precautions are not necessary for clients with normal or near-normal neutrophil counts, such as 5000/mm3.
Correct Answer is C
Explanation
Choice A reason: Encouraging an increase in oral intake is not necessary in this situation, as dark urine is not a sign of dehydration or fluid imbalance. Dark urine may be caused by certain foods, medications, or medical conditions, but it does not indicate a need for more fluids.
Choice B reason: Measuring the client's urinary output is not relevant to this situation, as dark urine is not a sign of urinary retention or obstruction. Urinary output may vary depending on fluid intake, activity level, or other factors, but it does not reflect urine color.
Choice C reason: Explaining that color change is normal is the appropriate action to take, as dark urine is a common and harmless side effect of carbidopa/levodopa, which is a combination drug used to treat Parkinson's disease by increasing dopamine levels in the brain. Carbidopa/levodopa can cause urine to turn brown, black, or red, but this does not affect the function or health of the kidneys or bladder.
Choice D reason: Obtaining a specimen for a urine culture is not necessary in this situation, as dark urine is not a sign of infection or inflammation. A urine culture may be indicated if the client has symptoms such as fever, pain, burning, frequency, or urgency, but it does not diagnose urine color
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