A client who is taking dextroamphetamine-amphetamine extended-release tablets for attention deficit hyperactivity disorder (ADHD), reports about having difficulty sleeping at night. Which assessment is most important for the nurse to obtain?

Determine what time the dose is taken.

Ask about the client's bedtime routine.

Inquire about perceived anxiety.

Determine daily caffeine intake.

Answer and Explanation

The Correct Answer is A

A) Determine what time the dose is taken: The timing of medication administration, especially for stimulant medications like dextroamphetamine-amphetamine, can significantly impact sleep quality. If the client is taking the medication too late in the day, its stimulant effects may interfere with their ability to fall asleep at night. Therefore, assessing the timing of medication administration is crucial to determine if it correlates with the reported difficulty sleeping.
B) Ask about the client's bedtime routine: While bedtime routine can influence sleep quality, it may not directly address the issue of difficulty sleeping related to medication use. However, understanding the client's overall sleep habits and bedtime routine can provide valuable information for developing sleep hygiene recommendations.
C) Inquire about perceived anxiety: Anxiety can contribute to sleep disturbances, but in this context, the primary concern is the potential impact of dextroamphetamine-amphetamine on sleep. While anxiety assessment is important in comprehensive care, it may not directly address the client's reported difficulty sleeping specifically related to medication use.
D) Determine daily caffeine intake: Caffeine intake can affect sleep quality, but it may not be as directly relevant to the reported difficulty sleeping in the context of medication use. However, it's still valuable information to assess as part of the overall evaluation of sleep habits and factors contributing to sleep disturbances.

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Correct Answer is B

Explanation

A) Monitoring blood pressure: Tamsulosin is an alpha-adrenergic blocker used to relax the muscles in the prostate and bladder neck, improving urinary flow in benign prostatic hyperplasia (BPH). Monitoring blood pressure is important because tamsulosin can cause orthostatic hypotension, especially when starting the medication or increasing the dose.
B) Assessing urine output: This is the correct answer. Tamsulosin can cause urinary retention, especially in patients with bladder outlet obstruction. Monitoring urine output helps assess for any signs of urinary retention or decreased urinary flow.
C) Obtaining daily weights: This is not typically necessary for monitoring the effects of tamsulosin. Changes in weight may occur due to other factors and are not directly related to the medication.
D) Performing a bladder scan: While performing a bladder scan may be indicated if there are specific concerns about urinary retention, assessing urine output is a more direct and immediate way to monitor for this adverse reaction.

A. Keep an oral liquid or glucose source available. B. Check blood glucose levels every six hours. C. Assess for hypoglycemia between meals. D. Provide meals at the same time this insulin is given.

Correct Answer is D

Explanation

A) Keep an oral liquid or glucose source available:
While it's essential to have a readily available source of glucose in case of hypoglycemia, ensuring consistency in meal timing is more critical for managing blood sugar levels in clients receiving insulin lispro. However, having a glucose source available is still important as a precautionary measure.

B) Check blood glucose levels every six hours:
Frequent monitoring of blood glucose levels is essential in managing diabetes, but checking levels every six hours may not be necessary for all clients. The frequency of blood glucose monitoring should be individualized based on factors such as the client's overall glycemic control, insulin regimen, meal timing, and activity level.

C) Assess for hypoglycemia between meals:
While assessing for hypoglycemia is important, especially in clients receiving insulin therapy, ensuring consistent meal timing is a more proactive measure to prevent hypoglycemia. Clients should ideally consume meals or snacks containing carbohydrates around the same time they administer rapid-acting insulins like insulin lispro to prevent blood sugar fluctuations.

D) Provide meals at the same time this insulin is given:
This is the correct intervention. Insulin lispro is a rapid-acting insulin that is typically administered just before meals to control postprandial blood sugar levels effectively. Providing meals at consistent times relative to insulin administration helps synchronize the peak action of the insulin with the rise in blood glucose that occurs after eating, minimizing the risk of hypoglycemia and hyperglycemia.

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A client who is taking dextroamphetamine-amphetamine extended-release tablets for attention deficit hyperactivity disorder (ADHD), reports about having difficulty sleeping at night. Which assessment is most important for the nurse to obtain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Correct Answer is B

Explanation

Which intervention is most important for the nurse to implement for a client with type 2 diabetes mellitus (DM) who is receiving insulin lispro?

Correct Answer is D

Explanation

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