A client who has been taking benzodiazepine sedative every night for two weeks wishes to stop taking them now. The nurse advises the client to:
continue taking the sedative and discuss slowly decreasing the dose with the physician.
take the last pill on a Friday so that extra sleep can be obtained on the weekend.
continue to take the pills since sleeping without them will be very difficult.
stop taking the medication and take an antihistamine instead.
The Correct Answer is A
A. Gradual tapering of benzodiazepines under medical supervision is recommended to minimize withdrawal symptoms and rebound insomnia. The client should continue taking the medication as prescribed while discussing a tapering plan with their physician.
B. Abruptly stopping benzodiazepines can lead to withdrawal symptoms, including rebound insomnia, anxiety, agitation, and even seizures. Planning to stop medication on a specific day without medical guidance can increase the risk of withdrawal symptoms occurring during the workweek.
C. While it may be challenging to sleep without benzodiazepines initially, continued use can lead to dependence and tolerance, making it even more challenging to discontinue them in the future. Gradual tapering under medical supervision is the preferred approach.
D. Antihistamines are not typically used as substitutes for benzodiazepines in managing insomnia. Additionally, abruptly stopping benzodiazepines and switching to another medication without medical guidance can lead to withdrawal symptoms and inadequate management of insomnia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. Calling the prescribing physician to clarify the order is the most appropriate action in this situation. Direct communication with the physician allows the nurse to express concerns, seek clarification, and ensure that the medication order is appropriate and safe for the client.
A. Administering a medication at a higher than recommended dose could potentially harm the client and is not in line with safe medication administration practices. It's essential to follow the established guidelines and recommendations for medication dosing to avoid adverse effects or complications.
B. Holding the ordered dose and documenting the rationale is an appropriate initial action. This allows the nurse to pause the administration of the medication, prevent potential harm to the client, and provide a clear record of the decision-making process. Holding the dose also provides an opportunity for further clarification with the prescribing physician.
C. While reporting a mistake to the pharmacy is important, it may not be the most immediate action to take when dealing with a higher than recommended dose of medication. Direct communication with the prescribing physician is necessary to clarify the order and ensure appropriate action is taken promptly.
Correct Answer is B
Explanation
B. Elevating the head of the bed to 30-45 degrees is the recommended position for administering enteral feeding to reduce the risk of aspiration. This semi-upright position helps promote gastric emptying and reduces the likelihood of reflux or regurgitation of the feed into the lungs. It also allows for better tolerance of the feeding and minimizes the risk of complications.
A. Positioning the client on the left side with the knees bent is not typically recommended for enteral feeding. This position may increase the risk of aspiration, especially if the client has impaired swallowing or if there are issues with gastric emptying. It may also not be the most comfortable or practical position for administering enteral feeding.
C. Positioning the client on the right side with a pillow behind the back is not a standard practice for administering enteral feeding. This position may not provide optimal access for administering the feed, and it does not offer the benefits of head elevation to reduce the risk of aspiration.
D. Elevating the head of the bed to only 15 degrees may not provide sufficient upright positioning to reduce the risk of aspiration during enteral feeding. While it is better than lying completely flat, a higher degree of elevation (30-45 degrees) is generally recommended for optimal safety and effectiveness of enteral feeding.
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