A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following is the priority nursing action?
Administer flumazenil (Romazicon).
Identify the client’s level of orientation.
Infuse IV fluids.
Prepare the client for gastric lavage.
A nurse is caring for a client who is to begin taking escitalopram (Lexapro) for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the use of this medication?
“I will take the medication at bedtime.”
“I will need follow a low-sodium diet while taking this medication.”
“I need to discontinue this medication slowly.”
“I probably won’t desire intimacy during the first days of treatment.”
A nurse is providing teaching to a client who has a new prescription to start buspirone (BuSpar) in place of diazepam (Valium). The client has a history of panic disorder and cirrhosis of the liver. The client asks why his provider is making the medication change. Which of the following statements is an appropriate response by the nurse?
“Diazepam can cause seizures as an adverse effect.”
“Diazepam is not indicated for the treatment of panic disorder.”
“Buspirone is a safe medication for clients who have liver dysfunction.”
“Buspirone has less risk for dependency than other treatment options.”
A nurse working in a mental health clinic is caring for a client who has obsessive-compulsive disorder and recently started a new prescription for buspirone (BuSpar). The client tells the nurse that the medication has not helped him sleep and that he is still having obsessive compulsions. Which of the following statements is an appropriate response by the nurse?
“It may take several weeks before you feel like the medication is helping.”
“Take the medication just before bedtime to promote sleep.”
“You should take the medication on an as-needed basis when you experience obsessive urges.”
“Your provider may need to increase your prescription due to developing tolerance.”
A nurse is caring for a client who takes paroxetine (Paxil) to treat posttraumatic stress disorder. The client states that he grinds his teeth during the night, which causes jaw pain. The nurse should identify which of the following as possible measures to manage the client’s bruxism? (Select all that apply.)
Concurrent administration of buspirone
Administration of a different SSRI
Use of a mouth guard
Changing to a different class of antianxiety medication
Increasing the dose of paroxetine
A nurse is caring for a client who has a new prescription for phenelzine (Nardil) for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?
Orthostatic hypotension
Hearing loss
Gastrointestinal bleeding
Weight loss
A nurse is providing teaching to a client who has a new prescription for amitriptyline (Elavil) for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.)
Expect therapeutic effects in 24 to 48 hr.
Discontinue the medication after a week of improved mood.
Change positions slowly to minimize dizziness.
Decrease dietary fiber intake to control diarrhea.
Chew sugarless gum to prevent dry mouth.
A nurse is providing follow-up dietary teaching for a client who recently was prescribed phenelzine (Nardil). When reviewing the client’s dietary log, which of the following foods requires a need for further teaching?
Cottage cheese
Banana bread
Apple pie
Grilled steak
A nurse is providing discharge teaching to a client who is to begin taking fluoxetine (Prozac) for posttraumatic stress disorder. Which of the following statements is appropriate for the nurse to include in the teaching?
“You may have a decreased desire for intimacy while taking this medication.”
“You should take this medication at bedtime to help promote sleep.”
“You will have fewer urinary adverse effects if you urinate just before taking this medication.”
“You’ll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication.”
A nurse is caring for a client who has been taking sertraline (Zoloft) for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome?
Bruising
Fever
Abdominal pain
Rash
A nurse is reviewing laboratory findings and notes that a client’s plasma lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?
Perform immediate gastric lavage.
Prepare the client for hemodialysis.
Administer an additional oral dose of lithium.
Request a stat repeat of the laboratory test.
A nurse is caring for a client who has a new prescription for lithium carbonate (Lithobid). When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following?
Avoid the use of acetaminophen for headaches.
Restrict intake of foods rich in sodium.
Decrease fluid intake to less than 1,500 mL daily
Limit aerobic activity in hot weather.
A nurse in a primary care clinic is assessing a client who takes lithium carbonate (Lithotabs) for the treatment of bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication?
Severe hypertension
Coarse tremors
Constipation
Urinary retention
A nurse is caring for a client who has a new prescription for valproic acid (Depakote). The nurse should instruct the client that while taking this medication he will need to have which of the following laboratory tests completed periodically? (Select all that apply.)
Thrombocyte count
Hematocrit
Amylase
Liver function tests
Potassium
A nurse is teaching a female client who has bipolar disorder about her new prescription for lithium carbonate (Lithobid). Which of the following is appropriate for the nurse to include in the teaching? (Select all that apply.)
An adverse effect of this medication is amenorrhea.
An antidepressant is combined with lithium therapy during phases of mania.
Take this medication with food or a glass of milk.
Avoid pregnancy while taking this medication.
Thyroid function is assessed prior to lithium therapy.
A nurse is teaching a client who has schizophrenia strategies to cope with anticholinergic effects of fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects?
Take the medication in the morning to prevent insomnia.
Chew sugarless gum to moisten the mouth.
Use cooling measures to decrease fever.
Take an antacid to relieve nausea.
A nurse is assessing a male client who recently began taking haloperidol (Haldol). Which of the following findings is the highest priority to report to the provider?
Shuffling gait
Neck spasms
Drowsiness
Impotence
A nurse is providing discharge teaching for a client who has a new prescription for clozapine (Clozaril). Which of the following statements is appropriate for the nurse to include in the teaching?
“You should have a high-carbohydrate snack between meals and at bedtime.”
“You are likely to develop hand tremors if you take this medication for a long period of time.”
“You may experience temporary numbness of your mouth after each dose.”
“You should have your white blood cell count monitored every week.”
A nurse performs an Abnormal Involuntary Movement Scale (AIMS) assessment on a client who began taking loxapine 2 years ago for the treatment of schizophrenia. Findings include lip smacking, tongue protrusion, and facial grimacing. The nurse should suspect which of the following?
Parkinsonism
Tardive dyskinesia
Anticholinergic effects
Akathisia
A nurse is preparing to perform a follow-up assessment on a client who takes chlorpromazine (Thorazine) for the treatment of schizophrenia. The nurse should expect to find the greatest improvement in which of the following manifestations? (Select all that apply.)
Disorganized speech
Bizarre behavior
Impaired social interactions
Hallucinations
Decreased motivation
A nurse in a provider’s office is providing instructions to a client who has a new prescription for lorazepam (Ativan). The nurse should inform the client that which of the following are adverse effects of lorazepam? (Select all that apply.)
Incoordination
Euphoria
Pruritus
Flatus
Amnesia
A nurse is caring for a client who is receiving moderate sedation with diazepam (Valium) IV. The client is oversedated. Which of the following medications should the nurse anticipate administering to this client?
Ketamine (Ketalar)
Naltrexone (ReVia)
Flumazenil (Romazicon)
Fluvoxamine (Luvox)
A nurse is teaching a client who has a new prescription for ramelteon (Rozerem) about the medication. The nurse should instruct the client to avoid which of the following foods while taking this medication?
Eggs
Grapefruit juice
Whole-grain bread
Chicken
A client is admitted to undergo a surgical procedure. The nurse should be aware that which of the following preexisting conditions may be a contraindication for the use of ketamine (Ketalar) as an intravenous anesthetic for this client?
Peptic ulcer disease
Breast cancer
Diabetes mellitus
Schizophrenia
A nurse is providing instructions to a female client who has a new prescription for zolpidem (Ambien). Which of the following instructions should the nurse include?
Notify the provider if you plan to become pregnant.
Take the medication 1 hr before you plan to go to sleep.
Allow at least 6 hr for sleep when taking zolpidem.
To increase the effectiveness of zolpidem, take it with a bedtime snack.
