The nurse admits a client with a diagnosis of stage 4 cancer. The client has a prescription to wear a subcutaneous morphine sulfate patch for pain. The client is short of breath and difficult to arouse.

While performing a head-to-toe assessment, the nurse discovers four patches on the client’s body. Which action should the nurse take first?

Remove the morphine patches.

Monitor blood pressure.

Apply oxygen face mask.

Administer a narcotic reversal drug.

Answer and Explanation

The Correct Answer is A

The client’s symptoms of being short of breath and difficult to arouse may indicate an overdose of morphine. The nurse should immediately remove the patches to prevent further absorption of the drug. After removing the patches, the nurse should continue to assess the client’s condition and take further actions as needed, such as administering a narcotic reversal drug or providing oxygen.

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Free Nursing Study Resources

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. Advise the client to stop taking the drug and contact the healthcare provider. B. Ask the client to describe her dietary intake history for the last several days. C. Instruct the to increase her intake of saturated fats over the next week. D. Obtain a stool to evaluate occult blood and fat content. E. Obtain a stool to evaluate occult blood and fat content.

Correct Answer is B

Explanation

Orlistat works by inhibiting the absorption of dietary fat in the intestines. The side eﬀects of faty stools and ﬂatus can be managed by reducing the intake of dietary fat. The nurse should ask the client to describe her dietary intake history for the last several days to determine if she has been consuming a diet high in fat.

Based on this information, the nurse can provide appropriate dietary advice to help manage these side eﬀects.

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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

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent faty stools and ﬂatus. Which action should the nurse take?

Correct Answer is B

Explanation

Which assessment data indicated to the nurse that a client is having an anaphylactic reaction to a medication?

A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the nest information to evaluate the client’s therapeutic response to the drug?

A client who is taking albendazole reports experiencing fatigue, nausea, and dark urine. The nurse observes a yellowing of the client’s skin and sclera. Which lab results should the nurse review?

Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal toenail infection, which assessment finding is most important for the nurse to address?

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this patient’s plan of care?

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?

The home health nurse observes a client self-administering an epinephrine injection using an auto-injector pen. Which client action requires intervention by the nurse?