A client tells the nurse that the arthritis pain is not relieved by 400 mg of ibuprofen every 4 hours, so the client doubles the dose. What is the nurse's best response?

That much ibuprofen should relieve your pain.

You probably should ask your healthcare provider if it is acceptable.

That amount is greater than the recommended daily amount. Discussing your increased pain with your healthcare provider is important.

Ibuprofen is eliminated by the kidneys. It would be important for your healthcare provider to order BUN and creatinine levels to determine if the increased dose is safe.

Answer and Explanation

The Correct Answer is C

A. That much ibuprofen should relieve your pain: This response is dismissive of the client's subjective experience of pain and fails to address safety. Pain threshold and intensity vary among individuals regardless of standard dosing. It lacks the necessary education regarding the maximum daily limits of the medication.

B. You probably should ask your healthcare provider if it is acceptable: While referring to a provider is necessary, this response is too passive and misses an immediate teaching opportunity. The nurse must identify the specific safety risk associated with the current dosage. It does not provide the rationale for the referral.

C. That amount is greater than the recommended daily amount. Discussing your increased pain with your healthcare provider is important: Doubling 400 mg every 4 hours results in 4800 mg daily, exceeding the 3200 mg maximum safe limit. This creates a high risk for gastrointestinal erosion and renal toxicity. The nurse must prioritize patient safety through education and provider consultation.

D. Ibuprofen is eliminated by the kidneys. It would be important for your healthcare provider to order BUN and creatinine levels to determine if the increased dose is safe: This focuses on diagnostic monitoring rather than the immediate danger of exceeding the maximum daily dose. While renal function is relevant, the priority is preventing toxicity by correcting the dosage. Staging the response around lab tests delays the necessary intervention.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. It is important for the client to increase fluid intake: While hydration is generally beneficial, it is not the most critical teaching point specific to tramadol administration. Tramadol does not typically cause significant urinary crystallization or acute dehydration. Other safety and onset parameters take precedence during initial patient education.

B. It may take 1 hour for pain to be effectively relieved: Tramadol is a centrally acting analgesic that requires systemic absorption and metabolic activation to exert its effects. Clients often expect immediate relief and may attempt to take extra doses if uninformed. Setting expectations for a 60-minute onset prevents accidental overmedication and manages anxiety.

C. The client should maintain an upright position for 30 minutes after receiving the medication: This instruction is typically reserved for bisphosphonates or medications that cause significant esophageal irritation. Tramadol does not carry a high risk for pill-induced esophagitis. Postural requirements are not a standard part of tramadol discharge or administration instructions.

D. The client should not have consumed foods or liquids with calcium for 1 hour before taking the medication: Calcium interference is a concern for certain antibiotics like tetracyclines or fluoroquinolones. Tramadol absorption is not significantly inhibited by calcium-rich foods or dairy products. This dietary restriction is unnecessary for the effective use of this analgesic medication.

A. The mother applies the prescribed number of otic drops into a sterile gauze and gently places it into the client's affected ear. B. The mother gently pulls the pinna of the ear down and back prior to administering otic drops. C. The mother retracts 0.5mL of the otic solution in a syringe prior to administration. D. The mother gently holds the tragus of the ear open while administering otic drops.

Correct Answer is B

Explanation

A. The mother applies the prescribed number of otic drops into a sterile gauze and gently places it into the client's affected ear: Otic medications must be instilled directly into the external auditory canal to reach the tympanic membrane or infected tissue. Absorbing the medication into gauze prevents the fluid from reaching the target anatomical site. This method results in subtherapeutic dosing and ineffective treatment.

B. The mother gently pulls the pinna of the ear down and back prior to administering otic drops: In children younger than 3 years, the external auditory canal is relatively short and curves upward. Pulling the pinna downward and backward straightens the canal to ensure the medication flows freely to the eardrum. This anatomical adjustment is essential for proper delivery in pediatric patients.

C. The mother retracts 0.5mL of the otic solution in a syringe prior to administration: Ear drops should be administered using the calibrated dropper provided with the specific medication container. Using a syringe for measurement can lead to dosing errors and potential trauma if the tip enters the canal. Precise drop counts are the standard for otic pharmacological safety.

D. The mother gently holds the tragus of the ear open while administering otic drops: The tragus should be gently massaged or pressed after instillation, not held open during the process. Pressing the tragus helps pump the medication deeper into the ear canal. Holding it open during administration does not provide any mechanical advantage for the distribution of the drops.

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A client tells the nurse that the arthritis pain is not relieved by 400 mg of ibuprofen every 4 hours, so the client doubles the dose. What is the nurse's best response?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When the nurse administers tramadol orally to a client for pain, which teaching point is most important to tell the client?

Correct Answer is B

Explanation

The nurse is teaching the mother of a 2-year-old client how to administer ear drops. The nurse recognizes correct return demonstration by the mother upon observing which technique?

Correct Answer is B

Explanation

The nurse is monitoring lab results for a client who is receiving acetaminophen (Tylenol) for chronic pain. Which lab result(s) may be abnormal?

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