A client who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) is experiencing gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the nurse include in this client’s teaching plan?

Resume a diet that consists of milk, cream, and bland foods.

Call the clinic if diarrhea or headache occurs when taking esomeprazole.

Once pain subsides, NSAID therapy can be resumed.

Notify the healthcare provider of the passage of black stools.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Resuming a diet that consists of milk, cream, and bland foods is not the most critical instruction for a client taking esomeprazole. While bland foods can help reduce gastric irritation, they do not address the primary concern of monitoring for serious side effects. Esomeprazole is a proton pump inhibitor (PPI) that reduces stomach acid, and dietary changes alone are not sufficient to manage potential complications.

Choice B reason:

Calling the clinic if diarrhea or headache occurs when taking esomeprazole is important, but it is not the most critical instruction. Diarrhea and headache are common side effects of esomeprazole, but they are usually not severe. The client should be aware of these potential side effects, but the primary concern is monitoring for signs of gastrointestinal bleeding.

Choice C reason:

Once pain subsides, NSAID therapy should not be resumed without consulting the healthcare provider. NSAIDs can cause significant gastrointestinal issues, including ulcers and bleeding. The client should be advised to avoid NSAIDs unless specifically directed by their healthcare provider.

Choice D reason:

Notifying the healthcare provider of the passage of black stools is the most critical instruction. Black stools can indicate gastrointestinal bleeding, which is a serious side effect of both NSAIDs and esomeprazole. Immediate medical attention is necessary if this occurs to prevent further complications.

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Correct Answer is C

Explanation

Choice A reason:

Placing the new patch on the client’s shoulder and leaving both patches in place for 12 hours is not recommended. Fentanyl patches are designed to be used one at a time, and overlapping patches can lead to an overdose due to excessive absorption of the medication1. The standard practice is to remove the old patch before applying a new one.

Choice B reason:

Removing the patch and consulting with the healthcare provider about the client’s pain resolution is a cautious approach. However, it is not necessary to consult the healthcare provider if the client denies pain and the patch is due for replacement. The nurse should follow the standard protocol for patch replacement.

Choice C reason:

Applying the new patch in a different location after removing the original patch is the correct action. This ensures that the medication is delivered effectively while preventing skin irritation and potential overdose. The new patch should be placed on a different area of intact skin to allow the previous site to recover.

Choice D reason:

Administering an oral analgesic and evaluating its effectiveness before applying the new patch is not appropriate in this scenario. The client is already receiving pain management through the transdermal patch, and additional oral analgesics are not necessary unless there is breakthrough pain. The focus should be on proper patch replacement

A. Those with allergies to chamomile, ragweed, or yarrow should not take feverfew. B. Feverfew may interact with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs). C. Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew. D. Increased anxiety and nervousness have been reported by those taking feverfew.

Correct Answer is A

Explanation

Choice A reason:

Those with allergies to chamomile, ragweed, or yarrow should not take feverfew because feverfew belongs to the Asteraceae/Compositae family, which includes these plants. Individuals allergic to these plants may experience allergic reactions to feverfew, such as skin rashes, swelling, and difficulty breathing. It is crucial to avoid feverfew in these cases to prevent severe allergic reactions.

Choice B reason:

Feverfew may interact with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), but this is not the most critical information compared to potential allergic reactions. Feverfew can inhibit platelet aggregation, which may increase the risk of bleeding when taken with NSAIDs or aspirin. However, the primary concern remains the potential for severe allergic reactions in sensitive individuals.

Choice C reason:

Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew, but these side effects are generally mild and manageable. While it is important to inform clients about possible gastrointestinal side effects, the risk of allergic reactions in individuals sensitive to chamomile, ragweed, or yarrow is more critical.

Choice D reason:

Increased anxiety and nervousness have been reported by those taking feverfew, but these side effects are less common and typically not severe. The primary concern should be the potential for allergic reactions, which can be life-threatening.

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A client who has been taking nonsteroidal anti-inflammatory drugs (NSAIDs) is experiencing gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the nurse include in this client’s teaching plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client’s upper back and the client denies pain. Which action should the nurse take?

Correct Answer is C

Explanation

A client who has been experiencing headaches since using the herbal remedy feverfew. Which information is important to include for this client?

Correct Answer is A

Explanation

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