A client with emphysema who is receiving a bronchodilator reports to the practical nurse (PN) feelings of jitters and dry mouth. Which finding should the PN record as a measure of the medication’s effectiveness?

Pupils equal and reactive to light

Heart rate 106 beats/minute

Respiratory rate 22 breaths/minute

Urine output 40 mL/hour

Answer and Explanation

The Correct Answer is C

Choice A reason: Pupils equal and reactive to light assess neurological status, not bronchodilator effectiveness. Bronchodilators, like albuterol, relax airway smooth muscles, improving breathing in emphysema. Pupil response is unrelated to respiratory function, making this choice irrelevant for evaluating the drug’s impact.

Choice B reason: Heart rate of 106 beats/minute may reflect a bronchodilator side effect, as beta-agonists stimulate cardiac beta receptors, causing tachycardia. However, it does not measure effectiveness, which is assessed by improved airway function, like respiratory rate, making this choice incorrect.

Choice C reason: Respiratory rate of 22 breaths/minute indicates bronchodilator effectiveness, as these drugs dilate airways, reducing work of breathing in emphysema. A normalized rate suggests improved airflow and oxygenation, directly reflecting the drug’s therapeutic action on bronchial smooth muscle relaxation.

Choice D reason: Urine output of 40 mL/hour monitors renal function, not bronchodilator efficacy. Bronchodilators target airway dilation, not fluid balance. This finding is unrelated to emphysema treatment or the drug’s respiratory effects, making it irrelevant for assessing medication effectiveness.

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Correct Answer is D

Explanation

Choice A reason: Eating aged cheeses, high in tyramine, is relevant for monoamine oxidase inhibitors, not TCAs, which do not interact with tyramine. This dietary habit does not affect TCA-related sleep disturbances, making it irrelevant for addressing the client’s early morning awakening.

Choice B reason: Taking a warm bath at night may promote relaxation but does not directly address TCA-related sleep issues. While helpful for general sleep hygiene, it is less critical than medication timing, which directly influences TCA’s stimulatory effects on sleep patterns.

Choice C reason: Dry mouth is a common TCA side effect due to anticholinergic properties but is not directly linked to sleep disturbances. It may cause discomfort but does not explain or address early morning awakening, making this information less relevant for sleep improvement.

Choice D reason: Taking TCAs upon rising can cause insomnia, as their stimulatory effects peak during sleep hours. TCAs increase norepinephrine, disrupting sleep architecture. Adjusting to bedtime dosing may reduce early morning awakening, making this information critical for optimizing sleep and therapeutic outcomes.

A. Ensure peak and trough serum levels are collected with the third medication dose B. Reassess the client’s pain 30 minutes after medication administration C. Observe the client daily for involuntary movements of the lips and tongue D. Initiate strict intake and output measurements and record every shift

Correct Answer is B

Explanation

Choice A reason: Peak and trough levels are relevant for drugs like antibiotics, not meloxicam, a nonsteroidal anti-inflammatory drug (NSAID). Meloxicam’s efficacy is assessed clinically, not via blood levels, as it reduces inflammation and pain, making this choice irrelevant for costochondritis management.

Choice B reason: Reassessing pain 30 minutes after meloxicam administration evaluates its effectiveness, as this NSAID inhibits cyclooxygenase, reducing prostaglandin-mediated inflammation and pain in costochondritis. Timely reassessment ensures adequate pain relief, guiding further interventions for breathing discomfort, making this the appropriate intervention.

Choice C reason: Involuntary lip and tongue movements are associated with antipsychotics, not meloxicam. This NSAID does not cause neurological side effects like tardive dyskinesia. Monitoring for this is irrelevant, as meloxicam’s primary concerns are gastrointestinal or renal, not movement disorders.

Choice D reason: Strict intake and output monitoring is unnecessary for meloxicam, which primarily affects inflammation, not fluid balance. While long-term use may impact kidneys, pain reassessment is more immediate for costochondritis, making this choice less relevant than evaluating therapeutic pain relief.

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A client with emphysema who is receiving a bronchodilator reports to the practical nurse (PN) feelings of jitters and dry mouth. Which finding should the PN record as a measure of the medication’s effectiveness?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with depression who is taking a tricyclic antidepressant (TCA) reports frequent early morning awakening and difficulty going back to sleep. Which information from the client is important for the practical nurse (PN) to obtain to improve the client’s sleep pattern?

Correct Answer is D

Explanation

The practical nurse (PN) is assisting with the plan of care (POC) for a client with costochondritis who is now experiencing increased discomfort in breathing. The client receives a prescription for meloxicam. Which intervention should the PN include in the client’s POC?

Correct Answer is B

Explanation

The practical nurse (PN) is caring for a client with costochondritis who is now experiencing increased discomfort in breathing. The client receives a prescription for meloxicam. Which intervention should the PN include in the client’s POC?

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