An elderly client with heart failure comet to the emergency room because of nausea, vomiting, and anorexia. Based on the client’s signs and symptoms, which data from the medical history has the most significance when planning this client’s care?

A coronary artery bypass procedure was performed in 1995.

Suﬀered with depression following death of spouse in 1999.

Digoxin and furosemide daily since 1996.

A Colonoscopy was performed for routine screening six months ago.

Answer and Explanation

The Correct Answer is C

Digoxin is a medication commonly used to treat heart failure by strengthening the heart's contractions and slowing down the heart rate. However, it can also cause nausea, vomiting, and loss of appetite, especially when levels in the body are too high. Furosemide is a diuretic medication that helps to remove excess ﬂuid from the body, which is often necessary in heart failure. However, it can also cause electrolyte imbalances, such as low potassium levels, which can contribute to nausea and vomiting.

Therefore, in a client with heart failure who is experiencing these symptoms, it is important to assess their medication regimen, including dosages and serum levels, to ensure that they are not experiencing medication side eﬀects or toxicity.

Adjustments may need to be made to the client's medication regimen to manage symptoms eﬀectively and prevent further complications. Options (a), (b), and (d) do not have as direct a correlation to the current symptoms and would not have the same level of significance when planning care for this client.

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Correct Answer is C

Explanation

The correct answer is C. Liver function lab results.

Choice A: Weight change in the last month

Weight change is a relevant factor to monitor in patients starting on antidepressants, including duloxetine, as some antidepressants can cause weight gain or loss. However, it is not the most critical information to obtain initially. Monitoring weight can help manage potential side effects and ensure the patient’s overall health, but it does not directly impact the immediate safety and efficacy of starting duloxetine.

Choice B: Recent use of other antidepressants

Recent use of other antidepressants is crucial information because combining duloxetine with other antidepressants, especially MAOIs (Monoamine Oxidase Inhibitors), can lead to serious interactions such as serotonin syndrome. This condition can be life-threatening and requires careful management. However, while this information is important, it is not as immediately critical as liver function tests when starting duloxetine.

Choice C: Liver function lab results

Liver function lab results are the most important information for the nurse to obtain. Duloxetine is metabolized in the liver, and patients with pre-existing liver conditions or impaired liver function are at higher risk for hepatotoxicity. Monitoring liver function is essential to prevent severe liver damage, which can be life-threatening. Baseline liver function tests help ensure that the patient can safely metabolize the medication and identify any potential issues early.

Choice D: Family history of mental illness

Family history of mental illness can provide valuable context for understanding the patient’s condition and potential genetic predispositions. It can also help in tailoring the treatment plan and anticipating the patient’s response to medication. However, while this information is useful for long-term management, it is not as immediately critical as liver function tests when initiating duloxetine therapy.

A. Take a tablet with a daily multivitamin. B. Crush the tablets and mix with pudding. C. Bedtime is the best time to take the tablet. D. Wait for 2 hours after meals to take the tablet.

Correct Answer is D

Explanation

Ferrous sulfate is best absorbed on an empty stomach. The nurse should instruct the client to wait for 2 hours after meals before taking the tablet to promote the best absorption of the medication. The client should also be advised not to crush the enteric-coated tablets as this can aﬀect the medication’s eﬀectiveness.

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An elderly client with heart failure comet to the emergency room because of nausea, vomiting, and anorexia. Based on the client’s signs and symptoms, which data from the medical history has the most significance when planning this client’s care?

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Naxlex Comprehensive Predictor Exams

The nurse is planning care for a patient with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

Correct Answer is C

Explanation

An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets. To promote the best absorption of the medication, which information should the nurse include in the discharge instructions?

Correct Answer is D

Explanation

A client with muscle spasticity receives a prescription for baclofen. Which information provided by the client requires additional instruction by the nurse?

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The nurse is caring for a client who is taking diclofenac, an NSAID drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client’s serum laboratory values is most important for the nurse to review?

An elderly client with heart failure comet to the emergency room because of nausea, vomiting, and anorexia. Based on the client’s signs and symptoms, which data from the medical history has the most significance when planning this client’s care?

Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the total level of calcium is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?

A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse eﬀect is most important for the nurse to report?

When caring for a client with diabetes insipidus who is receiving antidiuretic hormone intranasally, which serum lab test is most important for the nurse to monitor?