A client with peptic ulcer disease 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 of lethargy.
Decrease cigarette use to a pack per day.
Monitor for any signs of sexual dysfunction.
None
None
The Correct Answer is C
Choice A reason: Antacids can interfere with the absorption of cimetidine. It is generally recommended to avoid taking antacids within 1 hour before or after taking cimetidine to ensure optimal absorption. Therefore, taking cimetidine an hour after antacids is appropriate.
Choice B reason: Notifying the healthcare provider of lethargy is a correct statement, as it may indicate a serious side effect of cimetidine. Cimetidine can cause central nervous system effects, such as confusion, drowsiness, headache, and depression. Lethargy may also be a sign of anemia, which is another possible side effect of cimetidine. The nurse should instruct the client to report any unusual symptoms to the healthcare provider and monitor the client's blood count and liver function.
Choice C reason: Smoking has been shown to impair the effectiveness of cimetidine in treating ulcers and can delay healing. The goal should be complete smoking cessation rather than merely reducing cigarette use. Therefore, the statement about decreasing cigarette use to a pack per day indicates a misunderstanding and requires additional instruction by the nurse.
Choice D reason: Monitoring for any signs of sexual dysfunction is a correct statement, as it may indicate another side effect of cimetidine. Cimetidine can cause endocrine effects, such as gynecomastia, impotence, and decreased libido in men, and menstrual irregularities in women. The nurse should instruct the client to inform the healthcare provider if they experience any changes in their sexual function or reproductive health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Notifying the healthcare provider of the carbamazepine level is the most appropriate action for the nurse to take. Carbamazepine is an anticonvulsant drug that requires close monitoring of its serum levels to ensure therapeutic and safe effects. The normal reference range for carbamazepine is 4 to 12 mcg/mL or 16.9 to 50.8 mmol/L. A level of 84 mcg/L (35.6 mmol/L) is significantly higher than the upper limit and indicates toxicity. The nurse should report this finding to the prescriber immediately and hold the dose until further instructions.
Choice B reason: Administering the carbamazepine as prescribed is not the most appropriate action for the nurse to take. Giving the evening dose of carbamazepine when the morning level is already toxic can worsen the client's condition and cause serious adverse effects, such as confusion, drowsiness, ataxia, nystagmus, or coma. The nurse should not administer the medication without consulting the prescriber.
Choice C reason: Assessing the client for side effects of carbamazepine is an important action for the nurse to take, but it is not the most appropriate one. The nurse should assess the client for signs and symptoms of carbamazepine toxicity, such as nausea, vomiting, headache, blurred vision, or seizures. However, this action alone is not sufficient to address the problem. The nurse should also notify the prescriber and withhold the dose.
Choice D reason: Withholding this dose of the carbamazepine is a necessary action for the nurse to take, but it is not the most appropriate one. The nurse should not give the evening dose of carbamazepine when the morning level is already toxic, as this can increase the risk of complications. However, this action alone is not enough to resolve the issue. The nurse should also notify the prescriber and follow the appropriate interventions.
Correct Answer is C
Explanation
Choice A reason: Providing a heating pad to the client may provide some temporary relief, but it does not address the underlying cause of the neck discomfort, which is likely due to extrapyramidal side effects (EPS) of the antipsychotic medication.
Choice B reason: Obtaining a prescription for physical therapy services may be beneficial for the client's overall health and well-being, but it is not the best intervention for the acute problem of neck discomfort. Physical therapy may also require a referral and a waiting period, which would delay the relief for the client.
Choice C reason: Giving a PRN prescription for benztropine is the best intervention for the nurse to implement, as benztropine is an anticholinergic medication that can counteract the EPS of the antipsychotic medication. Benztropine can reduce the muscle stiffness and spasms that cause the neck discomfort.
Choice D reason: Obtaining an extra pillow for the client to use at night may help the client sleep better, but it does not address the neck discomfort during the day. It also does not treat the EPS of the antipsychotic medication, which may worsen over time.
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