A nurse is reinforcing teaching with a client who has schizophrenia and a new prescription for haloperidol. The nurse should instruct the client to avoid taking which of the following medications?

Diphenhydramine

Docusate sodium

Ibuprofen

Glucosamine

Answer and Explanation

The Correct Answer is A

A. Diphenhydramine. Diphenhydramine is a first-generation antihistamine with anticholinergic properties that can increase the risk of central nervous system (CNS) depression when taken with haloperidol. Both drugs can cause sedation, confusion, and impaired coordination, increasing the risk of falls and other complications. Additionally, combining them can worsen extrapyramidal symptoms (EPS) or lead to anticholinergic toxicity, making it an unsafe combination.

B. Docusate sodium. Docusate sodium is a stool softener used to prevent constipation. Haloperidol can cause constipation as a side effect due to its anticholinergic properties, so docusate sodium is safe and may even be beneficial in preventing bowel complications.

C. Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation. While it does not have a direct interaction with haloperidol, it should be used with caution in clients with a history of gastrointestinal issues or kidney disease. However, it does not pose a significant risk when taken alongside haloperidol.

D. Glucosamine. Glucosamine is a dietary supplement used to support joint health. It does not interact with haloperidol and does not have sedative or CNS effects. Clients taking haloperidol can safely use glucosamine if needed.

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Correct Answer is ["1"]

Explanation

Convert pounds to kilograms:

Conversion factor: 1 kg = 2.2 lb

=145 lb / 2.2 lb/kg

= 65.9 kg

Calculate the total daily dose:

Total daily dose (mg) = Weight (kg) × Dosage (mg/kg/day)

= 65.9 kg 3 mg/kg/day

= 197.7 mg/day

Calculate the dose per administration (divided into two doses):

Dose per administration (mg) = Total daily dose (mg) / Number of doses

=197.7 mg/day / 2 doses

= 98.85 mg/dose

Calculate the number of tablets per dose:

Number of tablets = Desired dose (mg) / Available dose (mg/tablet)

=98.85 mg/dose / 100 mg/tablet

= 0.9885 tablets

Round to the nearest whole number:

0.9885 tablets is 1 tablet

A. "Instruct the client's visitors not to operate the PCA pump.” B. "Check the client's pain level every 8 hours." C. "Diarrhea is an adverse effect of morphine PCA.” D. "Using morphine PCA increases the client's risk of toxicity."

Correct Answer is A

Explanation

A. "Instruct the client's visitors not to operate the PCA pump.” Only the client should press the PCA button to self-administer medication. Allowing visitors or family members to press the button ("PCA by proxy") increases the risk of over-sedation, respiratory depression, and opioid toxicity. The nurse should reinforce to visitors that only the client should control medication delivery based on their own pain level.

B. "Check the client's pain level every 8 hours." Pain assessment should be performed more frequently than every 8 hours when a client is receiving morphine PCA. Pain, sedation level, and respiratory status should be monitored every 1–2 hours initially and then at regular intervals as determined by hospital protocol to ensure effective pain management and prevent complications such as respiratory depression.

C. "Diarrhea is an adverse effect of morphine PCA." Morphine is an opioid analgesic that commonly causes constipation, not diarrhea. Opioids slow gastric motility, which can lead to delayed bowel movements, bloating, and discomfort. Clients on long-term opioid therapy often require stool softeners or laxatives to prevent opioid-induced constipation.

D. "Using morphine PCA increases the client's risk of toxicity." PCA pumps are designed with preset dose limits and lockout intervals to prevent overdose. While there is a risk of opioid toxicity if the system is misused (e.g., PCA by proxy or improper settings), PCA is actually safer than traditional opioid administration methods because it allows for precise dosing and patient-controlled pain management. Proper monitoring helps prevent complications.

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A nurse is reinforcing teaching with a client who has schizophrenia and a new prescription for haloperidol. The nurse should instruct the client to avoid taking which of the following medications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["1"]

Explanation

A nurse is reinforcing teaching with a newly licensed nurse about monitoring morphine patient-controlled analgesia (PCA). Which of the following information should the nurse include?

Correct Answer is A

Explanation

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