A client reports that the 30 mg extended release form of cyclobenzaprine has been the only medication that provided relief from lower back pain in the past. The client asks the nurse if the medication for chronic back pain could be prescribed on a monthly basis. Which is the best response from the nurse?

The medication has been recalled by the FDA and can no longer be prescribed.

You will have to have labs drawn monthly to renew your prescription.

You may build up a tolerance to that dose so it may have to be increased.

This medication is usually prescribed for a maximum use of 3 weeks.

Answer and Explanation

The Correct Answer is D

A. Cyclobenzaprine has not been recalled by the FDA and remains an approved medication for short-term use in muscle spasms. Providing inaccurate information undermines trust and does not appropriately address the client’s question. Therefore, this is not the best response.

B. Monthly laboratory monitoring is not a standard requirement for prescribing cyclobenzaprine. While some medications require routine lab work (e.g., liver or kidney function tests), cyclobenzaprine does not typically necessitate monthly labs for continuation. This response is misleading and does not address the appropriateness of long-term use.

C. While tolerance can develop with some medications, cyclobenzaprine is not intended for long-term dose escalation. Suggesting that the dose may need to be increased implies chronic use, which is inconsistent with clinical guidelines. This response does not address the safety concern regarding prolonged use.

D. This is the correct response. Cyclobenzaprine, particularly in its extended-release form, is indicated for short-term use, typically up to 2–3 weeks, because its effectiveness for longer durations has not been established and the risk of adverse effects (such as sedation, anticholinergic effects, and dependency-like patterns) increases with prolonged use. For chronic back pain, alternative long-term management strategies (e.g., physical therapy, non-opioid analgesics, or other interventions) are generally recommended.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Restricting daily fluid intake is a common intervention for clients with fluid overload to help prevent further accumulation. While it can help manage the condition over time, it does not provide immediate relief from the client’s acute symptoms such as pulmonary congestion or shortness of breath. Relying solely on fluid restriction could allow the client’s condition to worsen, increasing the risk of respiratory compromise and cardiovascular strain.

B. Weighing the client every morning is an essential tool for monitoring fluid status and detecting trends over time. A sudden weight gain, such as 2 pounds in one day, is a key indicator of fluid retention. However, this action is primarily for assessment and does not actively treat the current overload.

C. Maintaining accurate intake and output is critical for assessing fluid balance and monitoring the effectiveness of interventions such as diuretics or fluid restriction. Although it provides valuable information for ongoing care planning, it does not reduce the fluid overload causing the client’s immediate symptoms.

D. Administering the prescribed diuretic is the priority intervention in this scenario. The client demonstrates clinical signs of fluid volume excess, including bounding peripheral pulses indicating increased circulating blood volume, significant weight gain reflecting fluid retention, pitting ankle edema showing interstitial fluid accumulation, and moist crackles bilaterally suggesting pulmonary congestion. The diuretic promotes renal excretion of excess fluid and sodium, reducing intravascular and interstitial volume. This intervention directly alleviates symptoms, decreases the risk of pulmonary edema, lowers cardiac workload, and prevents further complications such as heart failure exacerbation. It is considered the highest priority action according to the ABC (Airway, Breathing, Circulation) framework, because untreated fluid overload can compromise respiratory function and lead to life-threatening complications.

A. Odynophagia B. Epigastric pain C. Dyspepsia D. Emesis

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A,B,C"},"C":{"answers":"A,B,C"},"D":{"answers":"A,B"}}

Explanation

Odynophagia (painful swallowing) – GERD: Odynophagia is more commonly associated with GERD, where stomach acid reflux irritates the esophagus, causing pain with swallowing. Gastritis and PUD primarily affect the stomach lining and may cause epigastric discomfort but usually not pain specifically during swallowing.
Epigastric pain – Gastritis, PUD, GERD: Epigastric pain is a common symptom for all three conditions. Gastritis involves inflammation of the stomach lining; PUD involves a mucosal defect in the stomach or duodenum; GERD can cause burning pain in the upper abdomen due to acid reflux. The timing and triggers (after meals, relief with antacids, or nocturnal pain) may help differentiate them clinically.
Dyspepsia (indigestion, bloating, discomfort) – Gastritis, PUD, GERD: Dyspepsia is a generalized upper abdominal discomfort seen in all three conditions. It may present as bloating, nausea, or a feeling of fullness after meals.
Emesis (vomiting) – Gastritis, PUD: Vomiting can occur in gastritis and PUD due to irritation of the gastric mucosa or obstruction from ulceration. While GERD may occasionally cause regurgitation, true emesis (forceful expulsion of stomach contents) is less typical in GERD.

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Naxlex Comprehensive Predictor Exams

A client's morning assessment includes bounding peripheral pulses, weight gain of 2 pounds (0.91 kg), pitting ankle edema, and moist crackles bilaterally. Which intervention is most important for the nurse to include in this client's plan of care?

Correct Answer is D

Explanation

The nurse is reviewing the assessment data. For each assessment finding, click to indicate if it is a symptom of gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), or gastritis. Each column must have at least one response option selected.

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A,B,C"},"C":{"answers":"A,B,C"},"D":{"answers":"A,B"}}

Explanation

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