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A nurse in a mental health clinic is caring for a client who has bipolar disorder and a prescription for an antipsychotic medication. The provider and nursing staff suspect the client is not adhering to his medication therapy. Which of the following interventions should the staff use to encourage the client's adherence? (Select all that apply.)

Rotate staff that administer the medications.

Engage the client in conversation following medication administration.

Use sustained-release forms.

Provide for once-daily dosing.

Perform mouth checks following the administration of the medication.

Answer and Explanation

Correct Answer : C,D,E

Answer:C, D, E

Rationale:

A) Rotate staff that administer the medications: Rotating staff can lead to inconsistency in communication and rapport with the client. A consistent nursing team is more likely to build trust and encourage adherence to medication therapy. Therefore, this intervention may not effectively promote adherence.

B) Engage the client in conversation following medication administration: While engaging the client in conversation can help build rapport and create a supportive environment, it may not be the most effective intervention for encouraging medication adherence. The priority should be focused on ensuring the client takes the medication as prescribed, rather than focusing on conversation after administration.

C) Use sustained-release forms: Sustained-release formulations can help with adherence by providing a more consistent therapeutic effect and reducing the number of doses a client needs to take throughout the day. This can simplify the medication regimen, making it easier for the client to adhere.

D) Provide for once-daily dosing: Once-daily dosing is beneficial for improving adherence because it reduces the complexity of the medication regimen. Clients are more likely to remember to take their medication if they only need to do so once a day.

E) Perform mouth checks following the administration of the medication: Performing mouth checks can help ensure that the client has actually taken the medication, especially if there is suspicion of non-adherence. This intervention can confirm that the medication is ingested and can serve as a prompt for adherence in future doses.

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Correct Answer is B

Explanation

A. "It doesn't really matter what time you take your medications as long as you don't skip any doses": This statement is incorrect because adherence to the prescribed dosing schedule is crucial for the effectiveness of medications. Inconsistent timing of doses can lead to suboptimal therapeutic outcomes or potential adverse effects.

B. "Let's work together to devise a time schedule that is convenient for you on a daily basis": This is the most appropriate instruction. Collaborating with the client to establish a medication schedule that aligns with their daily routine increases the likelihood of adherence. It promotes patient autonomy and empowers the client to take ownership of their medication regimen.

C. "You really shouldn't change the schedule we established here in the facility": While maintaining consistency in medication administration times is important, rigidly adhering to a schedule established during the facility stay may not always be feasible or practical for the client at home. Flexibility in adjusting the schedule to fit the client's lifestyle is essential for long-term adherence.

D. "We'll have to talk to your provider about switching to an alternative schedule": Switching to an alternative schedule should be considered only if the current schedule is not feasible for the client or if it compromises medication adherence. However, exploring options for adapting the existing schedule to better suit the client's needs should be attempted first before considering a switch.

Correct Answer is ["50"]

Explanation

To calculate the volume of phenytoin oral solution to administer per dose, we'll use the formula:

Volume(mL)=Totaldoseneeded(mg)/Concentrationofthemedication(mg/mL)

Given: Total dose needed per dose = 250 mg

Concentration of phenytoin oral solution = 25 mg/5 mL

(which simplifies to 5 mg/mL)

Substituting the given values into the formula:

Volume(mL)=250 mg/5 mg/mL

Volume(mL)=50 mL

Rounded to the nearest whole number, the nurse should administer 50 mL of phenytoin oral solution per dose.

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Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching for a client who has multiple medication prescriptions and must take the medications at specific intervals when at home. Which of the following instructions should the nurse include in the teaching?

Correct Answer is B

Explanation

Correct Answer is ["50"]

Explanation

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