A nurse is reinforcing teaching for a female client who has multiple sclerosis and a new prescription for dantrolene.
Which of the following client statements indicates an understanding of the teaching?.
"I should take this medication when my spasms are bad.”.
"I need to notify my provider if I don't get some relief from my muscle spasms within 3 months.”.
"I am glad this medication is safe to take if I get pregnant.”.
"I should return to the clinic to have my calcium level checked every 6 weeks.”.
The Correct Answer is B
The correct answer is Choice B
Choice A rationale: Dantrolene is a direct-acting skeletal muscle relaxant that works by inhibiting calcium release from the sarcoplasmic reticulum in muscle cells, thereby reducing muscle contraction. It is not intended for as-needed use during acute spasms but requires consistent dosing to maintain therapeutic levels. Intermittent use undermines its pharmacokinetics and may lead to subtherapeutic effects. The half-life of dantrolene is approximately 8.7 hours, and steady-state levels are necessary for optimal spasticity control in multiple sclerosis.
Choice B rationale: Dantrolene’s therapeutic effect on muscle spasticity may take several weeks to manifest due to its mechanism of action involving gradual reduction in intracellular calcium availability. If no improvement is noted within 3 months, it may indicate inadequate response or the need for dosage adjustment. Monitoring for efficacy is essential, as prolonged use without benefit increases risk of hepatotoxicity. Liver function tests should be monitored regularly. Normal ALT levels are 7–56 units/L; elevations may signal toxicity.
Choice C rationale: Dantrolene is classified as pregnancy category C, indicating that risk to the fetus cannot be ruled out. Animal studies have shown adverse effects, and there are no adequate human studies confirming safety during pregnancy. Therefore, it is not considered safe without careful risk-benefit analysis. Teratogenicity and fetal toxicity are concerns due to its action on muscle fibers and potential systemic effects. Pregnant clients should consult their provider before initiating or continuing dantrolene therapy.
Choice D rationale: Dantrolene does not directly affect calcium levels in the bloodstream. Its mechanism involves inhibition of calcium release within muscle cells, not systemic calcium metabolism. Routine calcium monitoring is not required unless the client has a separate condition affecting calcium homeostasis. Normal serum calcium levels range from 8.5 to 10.5 mg/dL. The primary lab concern with dantrolene is hepatotoxicity, necessitating regular liver function tests, not calcium surveillance. This statement reflects a misunderstanding of the drug’s effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Keeping the television on at all times can increase confusion and agitation in clients with Alzheimer’s disease due to the constant noise and changing images.
Choice B rationale:
Abstract pictures can be confusing and disorienting for clients with Alzheimer’s disease. It’s better to use simple, familiar images.
Choice C rationale:
Keeping familiar personal items in the client’s room can help orient the client to their surroundings and decrease confusion.
Choice D rationale:
Bright lighting can help reduce confusion and agitation in clients with Alzheimer’s disease by making the environment clear and easy to navigate.
So, the correct answer is C. Keep familiar personal items in client’s room.
Correct Answer is B
Explanation
Choice A rationale:
Constipation is not a common side effect of lithium carbonate.
Choice B rationale:
Thyroid enlargement is a known side effect of lithium carbonate. Lithium can cause hypothyroidism, which may result in an enlarged thyroid.
Choice C rationale:
Hyporeflexia is not typically associated with lithium carbonate use.
Choice D rationale:
Elevated blood pressure is not a common side effect of lithium carbonate.
So, the correct answer is B.
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