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 B
Explanation
Choice B reason: Vancomycin is an antibiotic that can treat serious bacterial infections that are resistant to other antibiotics. However, vancomycin can also cause nephrotoxicity, or damage to the kidneys, especially when given in high doses or for prolonged periods. Nephrotoxicity can lead to AKI, which is a sudden and severe decrease in kidney function that can cause fluid and electrolyte imbalances, acid-base disorders, uremia, and death. Therefore, the nurse should closely monitor the client who is receiving vancomycin for development of AKI by checking their serum creatinine and blood urea nitrogen (BUN) levels, urine output and specific gravity, and signs and symptoms of fluid overload or dehydration.
Choice A reason: Sucralfate is an anti-ulcer drug that forms a protective coating over the stomach lining and prevents further damage from acid or pepsin. Sucralfate does not cause nephrotoxicity or AKI and has minimal systemic absorption or side effects. Therefore, the nurse does not need to closely monitor the client who is taking sucralfate for development of AKI.
Choice C reason: Lorazepam is a benzodiazepine that can treat anxiety, insomnia, seizures, or alcohol withdrawal. Lorazepam does not cause nephrotoxicity or AKI and has low renal clearance or elimination. Therefore, the nurse does not need to closely monitor the client who is taking lorazepam for development of AKI.
Choice D reason: Digoxin is a cardiac glycoside that can treat heart failure or atrial fibrillation by increasing the force and efficiency of heart contractions and slowing down the heart rate. Digoxin does not cause nephrotoxicity
Correct Answer is D
Explanation
Choice D reason: Probenecid is a uricosuric drug that increases the excretion of uric acid in the urine by inhibiting its reabsorption in the kidneys. Uric acid is a waste product that results from the breakdown of purines, which are found in certain foods and drinks, such as meat, seafood, beer, and wine. Probenecid is used to treat gout, a type of arthritis that occurs when uric acid crystals accumulate in the joints and cause inflammation, pain, swelling, and stiffness. By lowering uric acid levels in the blood, probenecid can prevent gout attacks and reduce joint damage.
Choice A reason: Increasing the strength of the urine stream is not a purpose of probenecid, but rather a possible effect of some medications that relax or dilate the urinary tract muscles, such as alpha-blockers or anticholinergics. These medications can help to improve urinary flow and reduce symptoms of benign prostatic hyperplasia (BPH), or enlarged prostate gland, which can cause difficulty urinating or weak urine stream.
Choice B reason: Preventing the formation of kidney stones is not a purpose of probenecid, but rather a potential benefit of some medications that lower calcium or oxalate levels in the urine, such as thiazide diuretics or potassium citrate. These medications can help to prevent calcium oxalate stones, which are one of the most common types of kidney stones. Kidney stones are hard deposits of minerals and salts that form in the kidneys and can cause severe pain, nausea, vomiting, and blood in the urine.
Choice C reason: Decreasing pain and burning during urination is not a purpose of probenecid, but rather a desired outcome of some medications that treat urinary tract infections (UTIs), such as antibiotics or phenazopyridine. These medications can help to eliminate the bacteria that cause UTIs and relieve the discomfort and inflammation that they cause. UTIs are infections that affect the bladder, urethra, or kidneys and can cause frequent or urgent urination, pain or burning during urination, cloudy or foul-smelling urine, and fever.
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