A client has a new prescription for zolpidem, a hypnotic. The client tells the home health nurse that he plans to take a dose of the medication during the day because he is exhausted and needs to take a short afternoon nap prior to an evening activity in his home. Which action should the nurse take?

Remind the client to drink plenty of fluids when taking the medication.

Encourage the client to wait until bedtime to take the medication.

Advise the client to take the medication with the noon meal.

Explain that the client needs to allow for sleep time of at least two hours.

Answer and Explanation

The Correct Answer is B

A. Remind the client to drink plenty of fluids when taking the medication:

Drinking fluids with zolpidem is not a primary concern in this situation. The main issue is the timing of the medication.

When a client with a new prescription for zolpidem, a hypnotic, plans to take a dose of the medication during the day for a short afternoon nap, the nurse should take the following action:

B. Encourage the client to wait until bedtime to take the medication.

Explanation: Zolpidem is a medication primarily prescribed to help individuals with insomnia fall asleep more easily when taken at bedtime. Taking it during the day, especially for a short nap, can lead to drowsiness, impaired coordination, and reduced alertness during activities. It is not intended for daytime use or for short naps during the day. The nurse should encourage the client to take the medication as prescribed, at bedtime, to ensure safe and effective use.

C. Advise the client to take the medication with the noon meal:

Zolpidem is not typically taken with meals. Again, the primary concern is the timing of the medication.

D. Explain that the client needs to allow for sleep time of at least two hours:

While it's important to allow for sufficient sleep time after taking zolpidem to minimize the risk of impaired alertness and coordination, the client should be encouraged to take the medication at bedtime rather than during the day to ensure it works as intended.

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Correct Answer is C

Explanation

A. Ingestion of St. John's Wort doesn't significantly affect sodium intake.

B. While St. John's Wort is used by some people to treat depression, it's not the most significant factor in this situation where graft rejection is a concern.

The most significant information about this finding is:

C. Wort can decrease plasma concentrations of cyclosporine.

Explanation:

Cyclosporine is an immunosuppressive medication commonly used in transplant recipients to prevent graft rejection. St. John's Wort is known to induce liver enzymes responsible for drug metabolism, which can lead to a decrease in the blood levels of certain medications, including cyclosporine. This can potentially render the immunosuppressive effects of cyclosporine less effective, increasing the risk of graft rejection. Therefore, the interaction between St. John's Wort and cyclosporine is of utmost significance in this situation.

D. St. John's Wort is unlikely to decrease the need for corticosteroids, which are often used in transplant patients as part of immunosuppressive therapy.

A. Take medication on an empty stomach. B. Consume foods that are high in iodine. C. Avoid the use of iron supplements. D. Administer levothyroxine at bed time.

Correct Answer is A

Explanation

A. Take medication on an empty stomach.

Explanation: Levothyroxine should be taken on an empty stomach, preferably in the morning at least 30 minutes to an hour before breakfast. This maximizes its absorption and effectiveness. Taking it with food, especially foods high in fiber, calcium, or iron, can interfere with absorption.

Why the other choices are incorrect:

B. Consume foods that are high in iodine:

While iodine is important for thyroid function, it is not necessary to consume foods high in iodine solely because of a levothyroxine prescription. The focus should be on consistent dosing and following instructions for administration.

C. Avoid the use of iron supplements:

This is generally good advice because iron supplements can interfere with levothyroxine absorption. However, it is not the primary instruction related to taking levothyroxine.

D. Administer levothyroxine at bedtime:

Levothyroxine is typically taken in the morning on an empty stomach to maximize absorption. Taking it at bedtime is not the recommended timing for this medication.

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Laboratory Test	Result	reference range
Serum Creatinine	1 mg/dl (88.4 μmol/L)	0.5-1.1 mg/dL (44-97 μmol/L)
BUN	9 mg/dl. (3.2 mmol/L)	10-20 mg/dl. (3.6-7.1 mmol/L)
Sodium	136 mEq/L (136 mmol/L)	136 to 145 mEq/L (136 to 145 mmol/L)
Potassium	6.1 mEq/L (6.1 mmol/L)	3.5 to 5 mEq/L (3.5 to 5 mmol/L)

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A client receives a new prescription for levothyroxine. Which statement made by client indicates to the nurse the education was effective?

Correct Answer is A

Explanation

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