A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

Bronchitis.

Diabetes mellitus.

Hypertension.

Hypercholesterolemia.

Answer and Explanation

The Correct Answer is C

A) Bronchitis: Methylphenidate, a central nervous system stimulant, is not contraindicated in clients with bronchitis. While caution may be warranted in individuals with respiratory conditions due to potential stimulant effects, bronchitis alone does not necessitate specific precautions or contraindications for methylphenidate use.

B) Diabetes mellitus: Methylphenidate use does not typically pose significant risks for individuals with diabetes mellitus. While stimulant medications may affect appetite and blood glucose levels, they are not contraindicated in clients with diabetes. Monitoring blood glucose levels may be prudent, but it is not the primary concern when reviewing the medical record before administering methylphenidate.

C) Hypertension: Reviewing the medical record for hypertension is essential before administering methylphenidate. Stimulant medications like methylphenidate can increase heart rate and blood pressure, potentially exacerbating hypertension or cardiovascular conditions. Clients with uncontrolled hypertension may require dose adjustments or alternative treatments to mitigate cardiovascular risks associated with methylphenidate use.

D) Hypercholesterolemia: Methylphenidate is not contraindicated in clients with hypercholesterolemia. While stimulant medications may have minor effects on lipid profiles, they are not typically considered significant enough to warrant specific precautions or contraindications in individuals with hypercholesterolemia.

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Correct Answer is C

Explanation

A) Intolerance to cold: Intolerance to cold is a common symptom of hypothyroidism, not a sign of taking too much levothyroxine sodium. Therefore, this symptom would not indicate an overdose of the medication.

B) Constipation: Constipation can be a symptom of hypothyroidism, and it may improve with appropriate thyroid hormone replacement therapy. It is not typically associated with taking too much levothyroxine sodium.

C) Restlessness: This is the correct answer. Restlessness, anxiety, nervousness, or feeling jittery are symptoms of hyperthyroidism, which can occur if the client is taking too much levothyroxine sodium. If the dose of levothyroxine is too high, it can lead to hyperthyroid symptoms, even though the medication is intended to treat hypothyroidism.

D) Decreased appetite: Decreased appetite is not a typical symptom of taking too much levothyroxine sodium. In fact, weight loss is more commonly associated with hyperthyroidism, which can occur if the dose of levothyroxine is too high. However, decreased appetite alone may not specifically indicate an overdose of levothyroxine.

A. Hold the dose of IV pantoprazole until the client has finished eating breakfast. B. Provide a PRN dose of antacid along with the scheduled medications. C. Instruct the client to take the dose of sucralfate PO while eating breakfast. D. Administer both of the medications before breakfast as scheduled.

Correct Answer is D

Explanation

A) Holding the dose of IV pantoprazole until the client has finished eating breakfast may delay the onset of action of the medication, as pantoprazole is typically administered before meals to maximize its effectiveness in reducing gastric acid secretion. Additionally, delaying the dose may not provide immediate relief for the client's he’rtburn symptoms.

B) Providing a PRN dose of antacid along with the scheduled medications may temporarily relieve the client's he’rtburn symptoms, but it does not address the underlying cause of peptic ulcer disease or prevent further gastric acid secretion, which is the primary goal of pantoprazole and sucralfate administration.

C) Instructing the client to take the dose of sucralfate PO while eating breakfast may interfere with the optimal absorption of the medication. Sucralfate forms a protective barrier over ulcers in the stomach and should be administered on an empty stomach to allow it to adhere to the gastric mucosa effectively.

D) Administering both of the medications before breakfast as scheduled is the most appropriate action. Pantoprazole is a proton pump inhibitor that reduces gastric acid production, and sucralfate forms a protective barrier over ulcers in the stomach. Administering these medications before breakfast allows them to work synergistically to reduce gastric acid secretion and protect the gastric mucosa, helping to alleviate the client's he’rtburn symptoms and promote ulcer healing.

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A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium?

Correct Answer is C

Explanation

A client with peptic ulcer disease (PUD) is scheduled to receive doses of pantoprazole IV and sucralfate PO before breakfast at 0730. The client reports experiencing heartburn when the nurse brings the scheduled medications. Which action should the nurse take?

Correct Answer is D

Explanation

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