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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Free Nursing Study Resources

Correct Answer is ["B","C","E"]

Explanation

Choice B reason: Ciprofloxacin is a fluoroquinolone antibiotic that can treat anthrax, a serious bacterial infection that can affect the skin, lungs, or digestive system. Ciprofloxacin can cause tendonitis or tendon rupture, especially in older adults or those who take corticosteroids. Tendonitis is the inflammation of a tendon, which is a tissue that connects muscle to bone. Tendon rupture is the tearing or breaking of a tendon. These conditions can cause severe pain, swelling, bruising, or difficulty moving the affected area. Therefore, the nurse should instruct the client to report any tendon pain or swelling to the healthcare provider immediately and stop taking ciprofloxacin until further evaluation.

Choice C reason: Increasing fluid intake while taking the medication is an instruction that should be included in the teaching plan, because ciprofloxacin can cause crystalluria, or the formation of crystals in the urine. Crystalluria can lead to kidney stones, kidney damage, or urinary tract obstruction. Therefore, the nurse should advise the client to drink at least 2 liters of water per day while taking ciprofloxacin to prevent crystalluria and maintain kidney function.

Choice E reason: Limiting exposure to sunlight and avoiding tanning beds is an instruction that should be included in the teaching plan, because ciprofloxacin can cause photosensitivity, or increased sensitivity to sunlight or artificial ultraviolet light. Photosensitivity can result in sunburn, rash, blisters, or skin discoloration. Therefore, the nurse should recommend the client to limit exposure to sunlight and avoid tanning beds while taking ciprofloxacin and for several days after finishing the course. The nurse should also suggest the client to wear protective clothing, sunglasses, and sunscreen when outdoors.

Choice A reason: Crushing and mixing the tablets with pudding if you have trouble swallowing the tablets is not an instruction that should be included in the teaching plan, but rather a contraindicated practice that can reduce the effectiveness of ciprofloxacin and increase its side effects. Ciprofloxacin tablets have a special coating that protects them from stomach acid and allows them to dissolve slowly in the intestine. Crushing them will destroy their coating and make them dissolve faster in the stomach. This can cause stomach irritation, nausea, vomiting, diarrhea, or reduced absorption of ciprofloxacin into the bloodstream. Therefore, the nurse should instruct the client to swallow the tablets whole and not chew or crush them.

Choice D reason: Using NSAIDs to relieve mild joint aches and pains caused by the medication is not an instruction that should be included in the teaching plan, but rather a risky behavior that can increase the risk of adverse effects from ciprofloxacin. NSAIDs are anti-inflammatory drugs that can reduce pain, fever, and inflammation. However, NSAIDs can also interact with ciprofloxacin and increase its concentration in the blood. This can lead to toxicity and serious side effects such as seizures, hallucinations, confusion, or liver damage. Therefore, the nurse should caution the client to avoid using NSAIDs while taking ciprofloxacin and consult with their healthcare provider before taking any other medications.

A. Diarrhea. B. Involuntary movements. C. Nausea. D. Unusual irritability.

Correct Answer is B

Explanation

Choice A reason: Diarrhea is a common side effect of metoclopramide, but it is not life-threatening or indicative of a serious reaction. The nurse should monitor the client's fluid and electrolyte status and provide supportive care.

Choice B reason: Involuntary movements, such as twitching, grimacing, or spasms, are signs of a rare but serious condition called tardive dyskinesia, which can be caused by metoclopramide. This condition can be irreversible and disabling, so the nurse should report it immediately and stop the medication.

Choice C reason: Nausea is the reason why the client is receiving metoclopramide, which is an antiemetic drug. If the client still experiences nausea, the nurse should assess the effectiveness of the medication and notify the prescriber if needed.

Choice D reason: Unusual irritability is not a common or serious side effect of metoclopramide. It may be related to other factors, such as stress, pain, or fatigue. The nurse should provide emotional support and reassurance to the client.

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Naxlex Comprehensive Predictor Exams

The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride tablets, which were prescribed because of a suspected anthrax exposure. Which instruction(s) should be included in the teaching plan? (Select all that apply.)

Correct Answer is ["B","C","E"]

Explanation

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

Correct Answer is B

Explanation

The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?

The nurse is caring for a client who has been taking ibuprofen. Which finding is most important for the nurse to report to the healthcare provider?

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

The nurse is providing instructions about a client's new medications. How should the nurse explain the purpose of probenecid, a uricosuric drug?

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?

A client with Parkinson's disease who is taking carbidopa/levodopa reports that urine appears to be darker in color. Which action should the nurse take?

The nurse prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's vital signs are temperature 99°F (37.22°C), heart rate 48 beats/minute, respirations 16 breaths/minute, and blood pressure (B/P) 150/90 mm Hg. Which action should the nurse take?