A client has a new prescription for diclofenac, a nonsteroidal antiinflammatory drug (NSAID). Which information in the client's history is of greatest concern to the nurse in monitoring the client's response to this medication?

Migraine headaches.

Chronic alcoholism.

Osteoarthritis.

Type 2 diabetes mellitus.

Answer and Explanation

The Correct Answer is B

A) Migraine headaches: While migraine headaches are significant for overall health management, they are less directly related to the risks associated with NSAID use compared to other conditions. Migraines do not typically influence the safety profile of NSAIDs.

B) Chronic alcoholism: Chronic alcoholism is a major concern because it significantly increases the risk of gastrointestinal complications with NSAID use. NSAIDs can cause gastric irritation, bleeding, and ulcers, and alcohol can exacerbate these risks, leading to severe gastrointestinal issues or liver damage.

C) Osteoarthritis: Osteoarthritis is a common indication for NSAID use and, therefore, does not pose an additional risk specific to the medication. NSAIDs are often prescribed to manage pain and inflammation associated with osteoarthritis.

D) Type 2 diabetes mellitus: Although diabetes mellitus requires careful management, it does not directly increase the risk of NSAID-related complications. However, clients with diabetes need to be monitored for overall health and medication effects, but chronic alcoholism poses a more immediate risk for NSAID use.

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Correct Answer is C

Explanation

A) Diarrhea: Diarrhea is a common side effect of many medications, including those used for nausea and vomiting. While it can be uncomfortable and may require management, it is generally less severe compared to neurological symptoms. Persistent diarrhea should be monitored and managed, but it does not typically indicate a serious underlying issue with metoclopramide.

B) Unusual irritability: Irritability can occur as a side effect of many medications and might be a sign of a mild central nervous system effect or a response to the stress of illness. While it is important to assess and address any changes in mood, unusual irritability is generally less urgent compared to neurological symptoms that could suggest more serious adverse effects.

C) Involuntary movements: Involuntary movements, such as tremors or muscle spasms, are significant concerns when a patient is on metoclopramide. These symptoms can indicate extrapyramidal side effects, which include tardive dyskinesia or other severe movement disorders. These conditions can be serious and potentially irreversible if not addressed promptly, making it crucial to report such symptoms immediately to the healthcare provider for further evaluation and intervention.

D) Nausea: Nausea is the primary symptom that metoclopramide is intended to treat, so its presence is expected and does not usually signal an adverse reaction to the medication. If nausea persists despite treatment, it might suggest the need for dose adjustment or an alternative treatment, but it is not an urgent adverse effect that requires immediate reporting compared to neurological symptoms.

Correct Answer is ["200"]

Explanation

Calculations:

Total volume of the IV bag = 200 mL

Infusion time = 1 hour

To calculate the infusion rate in mL/hr, we use the formula:

Infusion rate (mL/hr) = Total volume (mL) / Infusion time (hours)

Infusion rate (mL/hr) = 200 mL / 1 hour = 200 mL/hr

Therefore, the nurse should program the infusion pump to deliver 200 mL/hr.

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A client has a new prescription for diclofenac, a nonsteroidal antiinflammatory drug (NSAID). Which information in the client's history is of greatest concern to the nurse in monitoring the client's response to this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is C

Explanation

A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (DW) 200 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.)

Correct Answer is ["200"]

Explanation

A client has a prescription for heparin 1,000 units IV STAT. Several pre filled syringes of low molecular weight heparin are available in the client's medication drawer. Which action should the nurse implement?

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