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

Take the medication an hour after antacids.

Notify the healthcare provider (HCP) of lethargy.

Monitor for any signs of sexual dysfunction.

Decrease cigarette use to a pack per day.

Answer and Explanation

The Correct Answer is D

A. Take the medication an hour after antacids: Antacids can interfere with the absorption of cimetidine, so spacing them apart is a correct approach. This statement indicates appropriate understanding of medication timing and does not require further instruction.

B. Notify the healthcare provider (HCP) of lethargy: Cimetidine can cause central nervous system effects like confusion or lethargy, particularly in older adults or those with renal impairment. Reporting such symptoms is appropriate and reflects safe medication awareness.

C. Monitor for any signs of sexual dysfunction: Cimetidine has been associated with gynecomastia, decreased libido, and impotence in some cases. The client should be aware of and monitor for these potential effects.

D. Decrease cigarette use to a pack per day: Smoking impairs ulcer healing and increases gastric acid secretion, which can counteract the effects of cimetidine. Reducing to a pack per day is still harmful; the client should be encouraged to stop smoking entirely, not just cut back.

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Correct Answer is C

Explanation

A. When using the discus, have the client breathe out rapidly into the mouthpiece: Clients should exhale away from the mouthpiece before inhaling the medication. Breathing out into the mouthpiece can blow away the powdered medication, making the dose ineffective.

B. Offer the discus to the client for use during an acute asthma attack: Fluticasone and salmeterol are used for long-term control of asthma, not for immediate relief during an acute attack. A short-acting bronchodilator like albuterol is needed for acute symptom management.

C. Explain that the client should not use the discus more than twice daily: The fluticasone/salmeterol combination is typically prescribed for use twice daily. Exceeding the recommended frequency increases the risk of side effects such as throat irritation, infections, and cardiovascular effects.

D. Clients using the discus may experience decreased blood pressure: While beta-agonists can sometimes have cardiovascular effects, salmeterol is a long-acting beta-agonist primarily targeting the airways. Decreased blood pressure is not a common or expected side effect of fluticasone/salmeterol inhalers. Increased heart rate or palpitations are more potential cardiovascular effects, but significant hypotension is unlikely.

A. Use relaxation techniques to reduce excessive anxiety. B. Avoid alcohol and other sedatives while taking the medication. C. Move slowly from a sitting position to a standing position. D. Stop taking the medication if intended effect is not immediate.

Correct Answer is D

Explanation

A. Use relaxation techniques to reduce excessive anxiety: Incorporating non-pharmacological strategies such as relaxation exercises complements lorazepam therapy and can improve anxiety management. This statement reflects appropriate understanding and safe self-care practices.

B. Avoid alcohol and other sedatives while taking the medication: Lorazepam is a central nervous system depressant, and combining it with alcohol or other sedatives can lead to respiratory depression, increased sedation, and potentially life-threatening effects. This is an important and accurate precaution.

C. Move slowly from a sitting position to a standing position: Orthostatic hypotension and dizziness are common side effects of benzodiazepines like lorazepam. Changing positions slowly helps minimize the risk of falls, especially in older adults or those sensitive to the medication.

D. Stop taking the medication if intended effect is not immediate: Lorazepam has a relatively quick onset, but stopping it abruptly without consulting a healthcare provider is unsafe and may lead to withdrawal symptoms including increased anxiety, insomnia, tremors, and even seizures. Clients must understand that medication adjustments require medical guidance.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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