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?

Hypothyroidism.

Knee arthroplasty 1 month ago.

Hepatitis B infection.

Recent head injury.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Hypothyroidism is not directly related to the use of bupropion for smoking cessation. It is essential to consider the client's overall health, but in this context, it is not the most significant concern, so it does not need to be reported immediately.

Choice B rationale:

Knee arthroplasty one month ago is not a contraindication for bupropion use, but it is essential to consider postoperative precautions and mobility. However, it is not the most critical issue related to the client's request for smoking cessation medication, so it does not need immediate reporting.

Choice C rationale:

Hepatitis B infection is a concern but does not necessarily contraindicate the use of bupropion. The nurse should address this issue, but it is not the most urgent concern for the client's request for smoking cessation medication.

Choice D rationale:

Reporting a recent head injury is crucial because bupropion is contraindicated in clients with a history of seizures or conditions that lower the seizure threshold, such as recent head trauma. Seizures are a significant potential side effect of bupropion, and a recent head injury could increase the risk of seizures. Therefore, the nurse should report this finding immediately to ensure the client's safety.

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Correct Answer is C

Explanation

Choice A rationale:

"The client asked me to go on a date with him, but I refused.”. This statement does not demonstrate countertransference. It is a clear example of professional boundaries being maintained, as the staff nurse refused the client's request for a date, which is appropriate in the context of the nurse-client relationship.

Choice B rationale:

"The client needs to accept responsibility for his substance use.”. This statement does not indicate countertransference. It reflects a common and appropriate therapeutic goal, which is to help clients take responsibility for their actions and substance use disorder.

Choice C rationale:

"The client is just like my brother who finally overcame his habit.”. This statement represents countertransference. Countertransference occurs when a healthcare professional's emotions, attitudes, or past experiences influence their perceptions and interactions with a client. In this case, the staff nurse is making a connection between the client and their own brother, suggesting a personal bias based on past experiences. This can hinder the staff nurse's ability to provide objective care.

Choice D rationale:

"The client generally shares his feelings during group therapy sessions.”. This statement does not demonstrate countertransference. It is a straightforward observation of the client's behavior during group therapy sessions and does not involve any emotional or personal bias on the part of the staff nurse.

A. Withhold the next dose of the medication. B. Ask the client about a recent change in laundry detergent. C. Apply hydrocortisone cream on the client's rash. D. Explain that the medication causes a temporary rash.

Correct Answer is A

Explanation

The correct answer is: A. Withhold the next dose of the medication.

Choice A rationale: Lamotrigine can cause serious skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis. Any rash should be taken seriously, and the medication should be withheld immediately to prevent potential severe reactions1.

Choice B rationale: While a change in laundry detergent could cause a rash, it is less likely to be the cause if the rash appeared after starting lamotrigine.

Choice C rationale: Applying hydrocortisone cream may help with mild skin irritations, but it does not address the potential severity of a drug-induced rash.

Choice D rationale: Explaining that the medication causes a temporary rash is not appropriate without first assessing the severity of the rash and withholding the medication.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A charge nurse is discussing the care of a client who has a substance use disorder with a staff nurse.Which of the following statements by the staff nurse should the charge nurse identify as countertransference?

Correct Answer is C

Explanation

A nurse is caring for a client who receives lamotrigine daily for bipolar disorder and reports a rash on his arm. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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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?