A nurse is educating a client with MS about baclofen therapy. Which statement indicates a need for further teaching?

This drug helps relax my muscles and reduce spasticity."

"I should not drink alcohol while taking this medication."

"I can stop taking baclofen if my spasms improve."

"I might feel sleepy or weak when I start taking it."

Answer and Explanation

The Correct Answer is C

Rationale:

A. Baclofen is a centrally acting skeletal muscle relaxant that targets the GABA-B receptors in the spinal cord, inhibiting excitatory neurotransmission. By reducing the frequency and severity of muscle spasms, stiffness, and hypertonicity, it helps improve mobility, ADLs, and overall comfort in patients with MS. This demonstrates correct understanding of the therapeutic purpose of the medication.

B. Both baclofen and alcohol are CNS depressants, which can lead to additive effects such as excessive drowsiness, dizziness, hypotension, or impaired coordination, increasing the risk of falls or accidents. Avoiding alcohol ensures patient safety, especially during initiation or dose adjustments.

C. Stopping baclofen abruptly is dangerous. Sudden discontinuation can cause rebound spasticity, severe muscle rigidity, hallucinations, seizures, fever, and even life-threatening complications. Safe discontinuation requires a gradual tapering schedule under medical supervision. This statement indicates the patient does not understand the importance of safe medication management and the physiologic consequences of sudden withdrawal.

D. Drowsiness, fatigue, and generalized weakness are common CNS-related adverse effects of baclofen, particularly at the start of therapy or after dose increases. Educating patients about these effects helps them anticipate changes, avoid risky activities (e.g., driving or operating machinery), and adhere to the regimen while monitoring tolerance.

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Correct Answer is A

Explanation

Rationale:

A. HbA1C reflects average blood glucose over approximately 2–3 months by measuring the percentage of hemoglobin molecules that are glycated. This provides a long-term view of glucose control, helping guide therapy adjustments and predict risk for complications such as retinopathy, nephropathy, and neuropathy.

B. HbA1C does not measure ketones. Ketone testing is performed via urine dipstick or blood beta-hydroxybutyrate, which is used to detect ketoacidosis, not long-term glucose control.

C. Fasting blood glucose or point-of-care glucose testing reflects current blood sugar, not long-term control. HbA1C provides a historical average, rather than a single snapshot.

D. HbA1C does not measure pancreatic function or insulin production. Tests such as C-peptide or insulin levels are used to assess endogenous insulin production.

A. Inject air into NPH, inject air into Regular, draw Regular, draw NPH B. Inject air into Regular, draw Regular, inject air into NPH, draw NPH C. Inject air into Regular, inject air into NPH, draw NPH, draw Regular D. Inject air into NPH, draw NPH, draw Regular

Correct Answer is A

Explanation

Rationale:
A. When mixing NPH (intermediate-acting) and Regular (short-acting) insulin, air must first be injected into the NPH vial, then into the Regular vial, before drawing up the insulin. Drawing up the Regular insulin first ensures the short-acting insulin remains uncontaminated by NPH, which could alter its onset and peak. After the Regular insulin is drawn, the NPH dose is drawn, maintaining proper concentrations and ensuring safe, accurate administration.

B. Injecting air into Regular first and drawing Regular before NPH can result in contamination of the short-acting insulin with intermediate-acting insulin. This could affect the insulin’s onset, peak, and duration. Using the wrong sequence increases the risk of improper glucose control.

C. Drawing NPH before Regular increases the risk of contaminating the Regular insulin. Contamination can alter the pharmacokinetics of the short-acting insulin, making blood glucose management unpredictable. This sequence does not follow safe mixing guidelines.

D. Not injecting air into both vials before drawing the insulin can create a vacuum, making it difficult to withdraw the correct doses. This increases the chance of dosing errors and reduces the accuracy of the insulin administered.

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A nurse is educating a client with MS about baclofen therapy. Which statement indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient asks why the doctor ordered an HbA1C test instead of just checking fasting blood sugar. The nurse's best response is:

Correct Answer is A

Explanation

During a return demonstration, a nursing student prepares to mix NPH and Regular insulin. Which sequence of steps indicates correct technique?

Correct Answer is A

Explanation

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