A client with allergic rhinitis is taking the over-the-counter antihistamine diphenhydramine HCL. Which instruction is most important for the nurse to provide this client?

Do not take the medication more than once every 8 hours.

Take the medication with food to prevent gastric upset.

Avoid driving, since this medication causes drowsiness.

Use sugarless candy or gum to help prevent a dry mouth.

Answer and Explanation

The Correct Answer is C

A. Do not take the medication more than once every 8 hours:
Diphenhydramine is typically dosed every 4 to 6 hours, not just once every 8 hours. However, this instruction is less critical compared to addressing the safety concerns related to drowsiness.

B. Take the medication with food to prevent gastric upset:
Diphenhydramine is generally not known to cause significant gastric upset, so this instruction is less critical. The primary concern with diphenhydramine is its sedative effects rather than gastrointestinal issues.

C. Avoid driving, since this medication causes drowsiness:
Diphenhydramine is known to cause significant drowsiness and sedation. Advising the client to avoid driving is crucial to prevent accidents and ensure their safety, making this the most important instruction.

D. Use sugarless candy or gum to help prevent a dry mouth:
While diphenhydramine can cause dry mouth, using sugarless candy or gum is a helpful but secondary instruction. The primary concern with diphenhydramine is its sedative effect, which affects the client's ability to drive safely.

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Correct Answer is C

Explanation

A) Adding the herb can decrease the need for corticosteroids: There is no substantial evidence that St. John’s Wort affects the need for corticosteroids. Its primary interactions are with medications metabolized by the liver, particularly cyclosporine, rather than affecting corticosteroid requirements directly.

B) Ingestion of St. John's Wort can reduce the client's intake of sodium: St. John’s Wort does not impact sodium intake. Its known interactions are with drugs, particularly those metabolized by the liver, rather than affecting dietary intake or sodium levels.

C) St. John's Wort can decrease plasma concentrations of cyclosporine: St. John’s Wort is a potent inducer of cytochrome P450 enzymes, which can lead to decreased plasma levels of cyclosporine, an immunosuppressant crucial for preventing graft rejection. This interaction can result in subtherapeutic levels of cyclosporine and increase the risk of graft rejection.

D) The client probably used this herb to treat depression: While it is true that St. John’s Wort is commonly used for its antidepressant effects, this is not the most significant concern in the context of a renal transplant. The primary issue is its interaction with cyclosporine, which can significantly impact transplant outcomes.

A. Instruct the client that it is necessary to take nothing but water with the medication. B. Withhold the medication until the client's breakfast tray is available on the unit. C. Consult with a pharmacist about scheduling the dose one hour after the client eats. D. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk.

Correct Answer is A

Explanation

A. Instruct the client that it is necessary to take nothing but water with the medication:
Risedronate, a bisphosphonate used for osteoporosis, should be taken with a full glass of water on an empty stomach. The client should remain upright for at least 30 minutes after taking the medication to enhance absorption and reduce the risk of esophageal irritation. Milk and other beverages can interfere with the absorption of the medication.

B. Withhold the medication until the client's breakfast tray is available on the unit:
This would delay the medication unnecessarily. Risedronate should be taken on an empty stomach to ensure proper absorption.

C. Consult with a pharmacist about scheduling the dose one hour after the client eats:
This is not appropriate as risedronate should be taken on an empty stomach to ensure maximum absorption. Consulting a pharmacist in this context may lead to a misunderstanding of the medication's administration requirements.

D. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk:
Offering milk with risedronate is inappropriate as it interferes with the medication’s absorption. The client should only take the medication with water.

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A client with allergic rhinitis is taking the over-the-counter antihistamine diphenhydramine HCL. Which instruction is most important for the nurse to provide this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

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?

Correct Answer is A

Explanation

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