A nurse is obtaining a medical history from a client who is requesting a prescription for bupropion for smoking cessation. Which of the following assessment findings in the client's history should the nurse report to the provider?
Recent head injury
Hepatitis B infection
Hypothyroidism
Knee arthroplasty 1 month ago
The Correct Answer is A
A. Recent head injury:
A recent head injury is a potential concern when considering the prescription of bupropion. Bupropion can lower the seizure threshold, and head injuries might increase the risk of seizures. Therefore, it's important to report a recent head injury to the healthcare provider to assess the client's suitability for bupropion.
B. Hepatitis B infection:
Hepatitis B infection is not a contraindication for bupropion. However, the healthcare provider should be aware of the client's full medical history, including hepatitis B infection, to ensure appropriate monitoring and management, especially if the client is taking other medications or has liver function concerns.
C. Hypothyroidism:
Hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormones, is not a contraindication for bupropion. However, the healthcare provider should be aware of this condition to monitor the client appropriately, as thyroid function can influence the metabolism of medications.
D. Knee arthroplasty 1 month ago:
Knee arthroplasty (knee replacement surgery) performed one month ago is not a direct contraindication for bupropion use. However, the provider should be informed of recent surgeries or procedures, especially if the client is taking medications or undergoing physical therapy, to ensure there are no potential drug interactions or complications related to the recent surgery. It's essential to monitor for signs of infection or other complications post-surgery.
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Related Questions
Correct Answer is C
Explanation
A. Liraglutide 0.6 mg subcutaneously daily:
Liraglutide is a medication used to treat type 2 diabetes and obesity. It works by regulating blood sugar levels and reducing appetite. It has no direct relevance to the treatment of schizophrenia or psychosis. Schizophrenia is a mental health disorder, and antipsychotic medications are typically used to manage its symptoms.
B. Selegiline 6 mg transdermal patch daily:
Selegiline is primarily used to treat Parkinson's disease by enhancing the effects of dopamine in the brain. It is not indicated for schizophrenia or psychosis. While dopamine dysregulation is involved in both Parkinson's disease and schizophrenia, the mechanisms and treatments are different. Antipsychotic medications, not selegiline, are used to manage psychosis in schizophrenia.
C. Aripiprazole 400 mg IM every 4 weeks:
This is the correct choice. Aripiprazole is an atypical antipsychotic medication commonly used to treat schizophrenia and other psychotic disorders. The intramuscular (IM) formulation provides extended release, making it suitable for clients who may have difficulty adhering to daily oral medications. It helps manage psychosis, a common symptom of schizophrenia.
D. Lithium 600 mg PO three times per day:
Lithium is a mood stabilizer commonly used to treat bipolar disorder by preventing or reducing the intensity of manic episodes. It is not a first-line treatment for schizophrenia or psychosis. Antipsychotic medications are the primary choice for managing the symptoms of psychosis in schizophrenia. Lithium is not typically used to address the hallucinations and delusions associated with schizophrenia.
Correct Answer is A
Explanation
A. The nurse maintains confidentiality unless the client's safety is compromised:
Explanation: Maintaining confidentiality is a fundamental principle in nursing practice. Nurses are ethically and legally obligated to keep client information confidential, ensuring that the client's privacy is respected. Confidentiality builds trust between the nurse and the client, encouraging open communication. However, confidentiality can be breached if the client's safety is at risk, such as if they express suicidal or homicidal thoughts, indicating the need for intervention to ensure their well-being.
B. The nurse seeks to spend extra time specifically with the client each day:
Explanation: While it's important for nurses to spend adequate time with each client, seeking to spend extra time specifically with one client may create imbalances in care distribution. Nurses should strive to provide equitable care to all clients, addressing their needs based on assessments and care plans. Special attention to one client could lead to feelings of favoritism or neglect among other clients, affecting the therapeutic environment.
C. The client sees the nurse as an authority figure:
Explanation: Clients often view nurses as authority figures due to their expertise and role in healthcare. This perception can facilitate a therapeutic relationship, as clients may trust the nurse's guidance and care. However, this should be balanced with empathy and understanding to create a supportive and therapeutic environment.
D. The client regards the nurse as a friend:
Explanation: While a therapeutic nurse-client relationship aims for trust and rapport, it is not a friendship. The nurse maintains professional boundaries to provide objective care without personal bias. Friendship implies a level of personal involvement that can compromise the nurse's ability to make objective clinical decisions. A therapeutic relationship is built on trust, respect, empathy, and clear professional boundaries.
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