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. Begin therapy 1 week before the next normal menstrual cycle. B. Use condoms and a backup method of birth control to prevent pregnancy. C. Ensure a negative pregnancy test result 2 weeks before therapy. D. Call the healthcare provider immediately if there is a chance of conception.

Correct Answer is A

Explanation

A) Begin therapy 1 week before the next normal menstrual cycle:
Misoprostol is often prescribed to prevent gastric ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs) and is typically taken regularly with meals and at bedtime. The timing of therapy initiation is not necessarily linked to the menstrual cycle. Therefore, instructing the client to begin therapy specifically 1 week before the next normal menstrual cycle is incorrect and indicates a need for further teaching.

B) Use condoms and a backup method of birth control to prevent pregnancy:
Misoprostol is contraindicated during pregnancy due to its potential to induce uterine contractions and cause miscarriage or fetal abnormalities. Therefore, advising the client to use condoms and a backup method of birth control to prevent pregnancy while taking misoprostol is appropriate and aligns with safety precautions.

C) Ensure a negative pregnancy test result 2 weeks before therapy:
Confirming a negative pregnancy test result before initiating misoprostol therapy is essential because the medication can cause harm to a developing fetus. This instruction is correct and reinforces the importance of avoiding pregnancy while taking misoprostol.

D) Call the healthcare provider immediately if there is a chance of conception:
Given the teratogenic effects of misoprostol, advising the client to contact the healthcare provider immediately if there is a chance of conception is crucial. This instruction emphasizes the importance of avoiding pregnancy while taking the medication and seeking medical guidance promptly if pregnancy is suspected.

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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

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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