A client with a history of schizophrenia, and drug and alcohol abuse is admitted to the hospital for hepatitis. The nurse should contact the healthcare provider before implementing which prescription?

Acetaminophen 650 mg PO PRN.

Olanzapine 30 mg PO at bedtime.

Thiamine, USP 100 mg PO daily.

Ondansetron 8 mg IV PRN.

Answer and Explanation

The Correct Answer is A

Choice A reason: Acetaminophen is hepatotoxic, metabolized by the liver via cytochrome P450 to NAPQI, which depletes glutathione, causing necrosis in hepatitis. A compromised liver from alcohol or viral hepatitis increases toxicity risk, even at standard doses. Contacting the provider ensures safer analgesics, preventing further liver damage in this high-risk client.

Choice B reason: Olanzapine, an antipsychotic, manages schizophrenia by blocking dopamine D2 receptors. It is metabolized by the liver but has low hepatotoxicity risk compared to acetaminophen in hepatitis. No immediate contraindication exists, as it controls psychosis without significantly worsening liver function, making it safe to administer without delay.

Choice C reason: Thiamine (vitamin B1) is essential in hepatitis, particularly with alcohol abuse, preventing Wernicke’s encephalopathy from deficient glucose metabolism. It is liver-safe and beneficial, supporting neurological function without toxicity. Administering thiamine is appropriate, making it unnecessary to contact the provider before implementation.

Choice D reason: Ondansetron, an antiemetic, controls nausea in hepatitis via serotonin 5-HT3 receptor blockade. It is metabolized by the liver but has minimal hepatotoxicity, safe in liver disease. No contraindication exists, as it alleviates symptoms without worsening hepatitis, unlike acetaminophen, which poses significant liver risk.

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Correct Answer is B

Explanation

Choice A reason: A soft diet with milk products may worsen diverticulosis, as dairy can cause bloating or intolerance. High fiber and fluids prevent constipation, reducing diverticular pressure. This is inappropriate, per dietary management and gastrointestinal health guidelines for diverticulosis in nursing education.

Choice B reason: A high fiber diet and increased fluid intake prevent constipation, reducing pressure in diverticula and preventing complications like diverticulitis. This promotes bowel regularity, critical for managing diverticulosis, per evidence-based dietary recommendations and gastrointestinal health protocols in patient education for nursing care.

Choice C reason: Small frequent meals and sitting up after meals aid digestion but do not address diverticulosis-specific needs. High fiber and fluids directly prevent constipation, reducing diverticular strain. This is less effective, per dietary management and patient teaching standards for diverticulosis in nursing.

Choice D reason: A bland diet avoiding spicy foods is unrelated to diverticulosis, which requires fiber to prevent constipation. Spicy foods do not directly affect diverticula. High fiber and fluids are critical, per gastrointestinal health and dietary management guidelines for diverticulosis in nursing education.

A. Maintain client on strict bedrest. B. Limit fluid intake. C. Strain all urine. D. Login a high-calcium diet.

Correct Answer is C

Explanation

Choice A reason: Strict bedrest is not indicated for urolithiasis, as movement may aid stone passage by shifting ureteral dynamics. Severe flank pain from ureteral obstruction causes muscle spasms. Straining urine collects stones for analysis, identifying composition to guide treatment, making bedrest less critical than addressing the stone.

Choice B reason: Limiting fluid intake is contraindicated, as high fluids promote urine flow, aiding stone passage and diluting urinary solutes like calcium. Pain results from obstruction, and straining urine identifies stone type. Fluid restriction increases stone formation risk, making this harmful and counterproductive to urolithiasis management.

Choice C reason: Straining all urine collects stones for analysis, determining composition (e.g., calcium oxalate) to guide dietary and pharmacological prevention. Severe flank pain from ureteral obstruction highlights the need for stone identification. This addresses the pathophysiological cause, enabling tailored interventions to prevent recurrence and manage acute symptoms.

Choice D reason: A high-calcium diet is inappropriate, as most kidney stones are calcium-based. Dietary calcium moderation, based on stone analysis from straining urine, prevents recurrence. Pain management requires stone identification, not increased calcium intake, which could exacerbate stone formation, making this counterproductive for urolithiasis.

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A client with a history of schizophrenia, and drug and alcohol abuse is admitted to the hospital for hepatitis. The nurse should contact the healthcare provider before implementing which prescription?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When conducting discharge teaching for a client diagnosed with diverticulosis, which diet instruction should the nurse include?

Correct Answer is B

Explanation

The nurse is caring for a client with urolithiasis who reports severe flank and abdominal pain. Which action should the nurse implement?

Correct Answer is C

Explanation

A client with chronic kidney disease (CKD) is prescribed a low-potassium diet. Which food choice indicates to the nurse that the client understands the dietary restrictions?

Following a total thyroidectomy, the nurse plans to observe a client for complications. Which finding indicates that the client has developed a complication?

After administering lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, it is most important for the nurse to monitor which assessment finding?

The mental health team working with a homeless client with chronic schizophrenia establishes the treatment goal of, “Improvement in avolition prior to discharge.” Which behavior demonstrates achievement of this goal to the nurse?

A client is admitted to the hospital with suicidal ideation. When completing the health history and admission assessment interview, which client comment is most important for the nurse to document?