Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?
A. Family history of mental illness
Family history of mental illness is important information to consider when assessing the client's overall mental health history, but it is not directly related to the immediate safety and effectiveness of duloxetine.
B. Weight change in the last month.
Weight change in the last month is relevant to monitor for side effects of duloxetine, but it is not as critical as assessing liver function, which directly impacts the metabolism of the medication.
C. Liver function laboratory results.
When planning care for a client starting on duloxetine, it is most important for the nurse to obtain liver function laboratory results. Duloxetine is primarily metabolized in the liver, and it is important to assess the client's liver function before starting the medication to ensure that the liver can process the drug effectively and safely. Clients with impaired liver function may require dose adjustments or be at higher risk for adverse effects, so obtaining liver function test results is crucial for safe medication management.
D. Recent use of other antidepressants.
Recent use of other antidepressants is essential to avoid potential drug interactions, but it is not the most critical piece of information compared to assessing liver function, which directly affects the client's ability to process duloxetine.
This question is an excerpt from Nurse Dive's nursing test bank - Hesi Pharmacology Proctored Exam 2. Take the full exam now
Full Explanation
Choice A rationale; Family history of mental illness is important information to consider when assessing the client's overall mental health history, but it is not directly related to the immediate safety and effectiveness of duloxetine.
Choice B rationale: Weight change in the last month is relevant to monitoring for side effects of duloxetine, but it is not as critical as assessing liver function, which directly impacts the metabolism of the medication.
Choice C rationale: When planning care for a client starting on duloxetine, it is most important for the nurse to obtain liver function laboratory results. Duloxetine is primarily metabolized in the liver, and it is important to assess the client's liver function before starting the medication to ensure that the liver can process the drug effectively and safely. Clients with impaired liver function may require dose adjustments or be at higher risk for adverse effects, so obtaining liver function test results is crucial for safe medication management.
Choice D rationale: Recent use of other antidepressants is essential to avoid potential drug interactions, but it is not the most critical piece of information compared to assessing liver function, which directly affects the client's ability to process duloxetine.
Similar Questions
Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?
Reference Range:
Total Calcium [Reference Range: Adult 9 to 10.5 mg\/dL or 2.25 to 2.62 mmol\/L]
A. Administer both prescribed medications as scheduled.
This is not appropriate because the client's elevated calcium level requires immediate attention and further assessment by the healthcare provider before administering any medications that may further raise calcium levels.
B. Hold both medications until contacting the healthcare provider.
The client's total calcium level is significantly elevated, which may indicate hypercalcemia. Given the reference range for total calcium in adults is 9 to 10.5 mg/dL (2.25 to 2.62 mmol/L), a calcium level of 14 mg/dL (3.5 mmol/L) is abnormally high. Both calcitriol (active form of vitamin D) and calcium carbonate (calcium supplement) can increase calcium levels in the body. Before administering any medication, the nurse should hold both calcitriol and calcium carbonate and notify the healthcare provider of the elevated calcium level. The healthcare provider will determine the appropriate course of action and may adjust the dosage or temporarily discontinue the medications to prevent further complications related to hypercalcemia.
C. Hold the calcium carbonate, but administer the calcitriol as scheduled.
Holding calcium carbonate is a step in the right direction, but given the significant elevation of total calcium, it is best to hold both medications and consult the healthcare provider.
D. Hold the, calcitriol but administer the calcium carbonate as scheduled.
Holding calcitriol is a step in the right direction, but both medications should be held to prevent exacerbation of hypercalcemia until further instructions are received from the healthcare provider.
Full Explanation
Choice A rationale: This is not appropriate because the client's elevated calcium level requires immediate attention and further assessment by the healthcare provider before administering any medications that may further raise calcium levels.
Choice B rationale: The client's total calcium level is significantly elevated, which may indicate hypercalcemia. Given the reference range for total calcium in adults is 9 to 10.5 mg/dL (2.25 to 2.62 mmol/L), a calcium level of 14 mg/dL (3.5 mmol/L) is abnormally high. Both calcitriol (active form of vitamin D) and calcium carbonate (calcium supplement) can increase calcium levels in the body. Before administering any medication, the nurse should hold both calcitriol and calcium carbonate and notify the healthcare provider of the elevated calcium level. The healthcare provider will determine the appropriate course of action and may adjust the dosage or temporarily discontinue the medications to prevent further complications related to hypercalcemia.
Choice C rationale: Holding calcium carbonate is a step in the right direction, but given the significant elevation of total calcium, it is best to hold both medications and consult the healthcare provider.
Choice D rationale: Holding calcitriol is a step in the right direction, but both medications should be held to prevent exacerbation of hypercalcemia until further instructions are received from the healthcare provider.
A client with chemotherapy induced nausea receives a prescription for metoclopramide.
Which adverse effect is most important for the nurse to report?
A. Nausea.
Nausea is the symptom the medication is intended to treat, and it is expected that the client may have some level of nausea while undergoing chemotherapy. It is not the most important adverse effect to report in this scenario.
B. Diarrhea.
Diarrhea is not a common or significant adverse effect of metoclopramide. While it is essential to monitor for any gastrointestinal side effects, it is not the most important adverse effect to report in this case.
C. Involuntary movements.
Metoclopramide is a medication commonly used to treat nausea and vomiting, particularly related to chemotherapy. One of the significant adverse effects of metoclopramide is the potential to cause extrapyramidal symptoms, including involuntary movements such as dystonia, dyskinesia, and Parkinsonism. These extrapyramidal symptoms can be serious and may require immediate intervention or discontinuation of the medication. Therefore, it is essential for the nurse to closely monitor the client for any signs of involuntary movements and report them promptly to the healthcare provider for appropriate management.
D. Unusual irritability.
Unusual irritability is not a typical adverse effect associated with metoclopramide. While mood changes can occur with any medication, involuntary movements are a more concerning side effect that requires immediate attention and reporting.
Full Explanation
Choice A rationale: Nausea is the symptom the medication is intended to treat, and it is expected that the client may have some level of nausea while undergoing chemotherapy. It is not the most important adverse effect to report in this scenario.
Choice B rationale: Diarrhea is not a common or significant adverse effect of metoclopramide. While it is essential to monitor for any gastrointestinal side effects, it is not the most important adverse effect to report in this case.
Choice C rationale: Metoclopramide is a medication commonly used to treat nausea and vomiting, particularly related to chemotherapy. One of the significant adverse effects of metoclopramide is the potential to cause extrapyramidal symptoms, including involuntary movements such as dystonia, dyskinesia, and Parkinsonism. These extrapyramidal symptoms can be serious and may require immediate intervention or discontinuation of the medication.
Therefore, it is essential for the nurse to closely monitor the client for any signs of involuntary movements and report them promptly to the healthcare provider for appropriate management.
Choice D rationale: Unusual irritability is not a typical adverse effect associated with metoclopramide. While mood changes can occur with any medication, involuntary movements are a more concerning side effect that requires immediate attention and reporting.
The healthcare provider prescribes the antibiotic tetracycline HCI for an adult client that arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?
A. Take with orange juice to enhance Gl absorption.
Choice A rationale: Tetracycline should generally be taken on an empty stomach, as certain food and beverages, including orange juice, can interfere with its absorption. The nurse should instruct the client to take tetracycline with water and on an empty stomach unless otherwise specified by the healthcare provider.
B. Protect the skin from sunlight while taking the drug.
Choice B rationale: Tetracycline is an antibiotic that can make the skin more sensitive to sunlight, leading to an increased risk of sunburn and photosensitivity reactions. To prevent these adverse effects, the nurse should instruct the client to protect their skin from sunlight while taking the medication. This includes using sunscreen, wearing protective clothing, and avoiding prolonged sun exposure. It is essential to educate the client about this potential side effect to ensure their safety and minimize skin reactions during treatment.
C. Return to the clinic weekly to obtain serum drug levels.
Choice C rationale: Tetracycline does not require routine monitoring of serum drug levels. It is an antibiotic with a well-established dosing regimen, and monitoring drug levels is not necessary for its safe and effective use.
D. Take with milk or antacids to prevent gastrointestinal (GI) irritation.
Choice D rationale: While taking tetracycline with milk or antacids may help reduce GI irritation, it can also interfere with the absorption of the medication. Therefore, it is generally recommended to take tetracycline with water and on an empty stomach to ensure optimal absorption and effectiveness.
Full Explanation
Choice A rationale: Tetracycline should generally be taken on an empty stomach, as certain food and beverages, including orange juice, can interfere with its absorption. The nurse should instruct the client to take tetracycline with water and on an empty stomach unless otherwise specified by the healthcare provider.
Choice B rationale: Tetracycline is an antibiotic that can make the skin more sensitive to sunlight, leading to an increased risk of sunburn and photosensitivity reactions. To prevent these adverse effects, the nurse should instruct the client to protect their skin from sunlight while taking the medication. This includes using sunscreen, wearing protective clothing, and avoiding prolonged sun exposure. It is essential to educate the client about this potential side effect to ensure their safety and minimize skin reactions during treatment.
Choice C rationale: Tetracycline does not require routine monitoring of serum drug levels. It is an antibiotic with a well-established dosing regimen, and monitoring drug levels is not necessary for its safe and effective use.
Choice D rationale: While taking tetracycline with milk or antacids may help reduce GI irritation, it can also interfere with the absorption of the medication. Therefore, it is generally recommended to take tetracycline with water and on an empty stomach to ensure optimal absorption and effectiveness.