A client with peptic ulcer disease (PUD) receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Take the medication an hour after antacids.

Notify the healthcare provider (HCP) of lethargy.

Monitor for any signs of sexual dysfunction.

Decrease cigarette use to a pack per day.

Answer and Explanation

The Correct Answer is D

A. Take the medication an hour after antacids: Antacids can interfere with the absorption of cimetidine, so spacing them apart is a correct approach. This statement indicates appropriate understanding of medication timing and does not require further instruction.

B. Notify the healthcare provider (HCP) of lethargy: Cimetidine can cause central nervous system effects like confusion or lethargy, particularly in older adults or those with renal impairment. Reporting such symptoms is appropriate and reflects safe medication awareness.

C. Monitor for any signs of sexual dysfunction: Cimetidine has been associated with gynecomastia, decreased libido, and impotence in some cases. The client should be aware of and monitor for these potential effects.

D. Decrease cigarette use to a pack per day: Smoking impairs ulcer healing and increases gastric acid secretion, which can counteract the effects of cimetidine. Reducing to a pack per day is still harmful; the client should be encouraged to stop smoking entirely, not just cut back.

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Correct Answer is A

Explanation

A. Hold one nostril closed while spraying the other nostril: Closing one nostril while administering the spray ensures the medication is delivered more effectively into the nasal passages, allowing for better absorption and symptom control by maximizing the contact of the medication with the nasal mucosa.

B. Use the inhaler when first awakening in the morning: The specific timing of intranasal corticosteroid use may vary depending on the healthcare provider's instructions and the client's symptom pattern. While morning use can be beneficial due to peak allergy symptoms, it is not the most critical technique instruction. Proper administration ensures better drug efficacy regardless of timing.

C. Avoid shaking the inhaler immediately before using: Some nasal sprays, especially suspensions, require shaking to evenly distribute the medication. Advising not to shake could lead to inconsistent dosing and reduced effectiveness, depending on the specific medication.

D. Angle the tip of the inhaler upward while spraying: The inhaler tip should be angled slightly outward toward the ear, not straight upward, to target the correct nasal structures. Spraying directly upward could lead to discomfort or less effective drug delivery.

A. "I should take this medication only when I am having an asthma attack." B. "This medication will stop an asthma attack immediately." C. "I will take the tablet every evening to control my asthma." D. "I will not need to use my inhalers twice a day when I start this medicine."

Correct Answer is C

Explanation

A. "I should take this medication only when I am having an asthma attack.": Montelukast is not intended for acute asthma attacks. It is a maintenance medication taken daily to reduce airway inflammation and prevent symptoms, not to treat attacks in progress.

B. "This medication will stop an asthma attack immediately.": Montelukast does not act quickly enough to treat acute bronchospasm. Short-acting beta-agonists like albuterol are used for immediate relief during an asthma attack, not leukotriene modifiers.

C. "I will take the tablet every evening to control my asthma.": Montelukast is prescribed as a daily maintenance therapy, typically taken in the evening to help control chronic asthma symptoms and to reduce the frequency and severity of exacerbations over time.

D. "I will not need to use my inhalers twice a day when I start this medicine.": Even after starting montelukast, clients often still need to use inhaled corticosteroids or other maintenance inhalers. Montelukast is an adjunct therapy, not a replacement for inhaled medications.

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A client with peptic ulcer disease (PUD) receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is instructing a client with allergic rhinitis about the correct technique for using an intranasal inhaler. Which instruction is most important for the nurse to provide the client?

Correct Answer is A

Explanation

A client with chronic asthma receives a prescription for montelukast, a leukotriene modifier. Which statement by the client indicates to the nurse that medication teaching was effective?

Correct Answer is C

Explanation

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