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. Hemoglobin level increased to 12 g/dL (7.45 mmol/L): Epoetin alfa stimulates red blood cell production, and an increase in hemoglobin is the primary indicator of the drug’s effectiveness. A hemoglobin of 12 g/dL reflects a significant therapeutic improvement in anemia management for a client with CKD.

B. Reports of increased energy levels and decreased fatigue: Although feeling more energetic is a positive clinical sign, it is subjective and does not provide objective evidence of improved red blood cell production. Lab values are preferred for evaluating medication effectiveness.

C. Food diary shows increased consumption of iron-rich foods: Dietary improvements support erythropoiesis but are not the direct measure of epoetin alfa’s effect. The medication’s success is best gauged by the actual rise in hemoglobin, not dietary habits alone.

D. Takes concurrent iron therapy without adverse effects: Iron supplementation is often needed to maximize epoetin alfa’s effect, but merely tolerating iron therapy does not confirm that epoetin alfa is working to correct the anemia. The focus remains on hemoglobin response.

A. Statins, such as atorvastatin. B. Analgesics, such as acetaminophen. C. Anticoagulants, such as warfarin. D. Nitrates, such as nitroglycerin.

Correct Answer is D

Explanation

A. Statins, such as atorvastatin: Statins primarily lower cholesterol and have no significant interaction with sildenafil that would cause an urgent safety concern. Although monitoring for muscle-related side effects is important with statins, it is not the priority here.

B. Analgesics, such as acetaminophen: Acetaminophen is generally safe and does not interact dangerously with sildenafil. There is no immediate concern related to combining these two medications.

C. Anticoagulants, such as warfarin: There is a potential for increased bleeding risk when sildenafil is combined with anticoagulants, but this is generally not an acute, life-threatening interaction requiring immediate determination before other more critical concerns.

D. Nitrates, such as nitroglycerin: Taking sildenafil with nitrates can cause profound, life-threatening hypotension. Both sildenafil and nitrates can cause vasodilation, and their combined use can lead to a dangerous and potentially fatal drop in blood pressure. This combination is absolutely contraindicated, and the nurse must immediately assess whether the client uses any nitrate medication to prevent a serious adverse event.

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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

A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective?Reference Range:Hemoglobin (Hgb) [14 to 18 g/dL (8.7 to 11.2 mmol/L)]

Correct Answer is A

Explanation

Correct Answer is D

Explanation

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