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A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for smoking cessation. Which of the following assessment findings in the client's history should the nurse report to the provider?

Hepatitis B infection.

Knee arthroplasty 1 month ago.

Recent head injury.

Hypothyroidism.

Answer and Explanation

The Correct Answer is C

The correct answer is c. Recent head injury.

Rationale for choice c:

Bupropion lowers the seizure threshold.
Individuals with a history of head injury have an increased risk of seizures.
Administration of bupropion to a client with a recent head injury could significantly elevate the risk of seizure activity.
It's crucial for the provider to be aware of this risk and make an informed decision about whether to prescribe bupropion or consider alternative smoking cessation therapies.

Rationale for choice a:

Hepatitis B infection does not generally contraindicate the use of bupropion.
However, it's important to inform the provider of any underlying medical conditions for comprehensive assessment and management.

Rationale for choice b:

Knee arthroplasty 1 month ago is not a contraindication for bupropion use.
While pain management following surgery might be a consideration, bupropion is not known to interact with common analgesics used post-operatively.

Rationale for choice d:

Hypothyroidism also does not contraindicate bupropion use.
However, thyroid hormone levels should be monitored as bupropion may potentially impact thyroid function in some individuals.

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Correct Answer is D

Explanation

The correct answer is choice d. Sore throat. Choice A rationale: A random blood glucose level of 130 mg/dL is slightly elevated but not immediately concerning. It should be monitored, especially since clozapine can cause metabolic changes, but it is not the priority. Choice B rationale: A heart rate of 104/min is slightly elevated and could be a side effect of clozapine, which can cause tachycardia. However, it is not as urgent as other potential side effects. Choice C rationale: Nausea is a common side effect of many medications, including clozapine. While uncomfortable, it is not typically a priority concern unless it leads to severe dehydration or other complications. Choice D rationale: A sore throat can be a sign of agranulocytosis, a potentially life-threatening condition where the white blood cell count drops dangerously low. Clozapine is known to cause this condition, and it requires immediate medical attention.

A. Maintain consistency in assigning health care staff for the client. B. Demonstrate a sympathetic attitude toward the client when providing care. C. Provide consistent boundaries for the client. D. Encourage the use of countertransference for the client.

Correct Answer is C

Explanation

A.While consistency in staff assignment can be beneficial in many situations, clients with borderline personality disorder often exhibit splitting behavior, where they may see people as all good or all bad. It's more important to provide consistent boundaries rather than focusing solely on staff consistency, as this might inadvertently reinforce splitting behavior.

B.While being empathetic is important in nursing care, being overly sympathetic might reinforce dependency or manipulative behaviors commonly seen in borderline personality disorder. It's crucial to maintain a professional, empathetic, yet firm approach that includes setting and maintaining boundaries.

C.Clients with borderline personality disorder often struggle with boundary issues and can exhibit behaviors such as manipulation, splitting, and impulsivity. Providing consistent boundaries helps create a sense of stability and predictability, which is therapeutic and helps the client learn appropriate interpersonal skills.

D.Encouraging the use of countertransference is not appropriate and can lead to an unprofessional and emotionally charged nurse-client relationship, which can be harmful to the therapeutic process. Instead, nurses should be aware of and manage their own feelings to provide effective and impartial care.

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A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for smoking cessation. Which of the following assessment findings in the client's history should the nurse report to the provider?

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A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for smoking cessation. Which of the following assessment findings in the client's history should the nurse report to the provider?