A nurse is preparing to administer buspirone 7.5 mg PO every 12 hr to a client. The amount available is buspirone 15 mg/tablet. How many tablets should the nurse administer per dose?

(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Answer: D. "I’ll take this medicine first thing in the morning."

A. "I should expect to feel better after 24 hours of starting this medication."
This statement indicates a misunderstanding of the medication's pharmacodynamics. Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), generally requires a minimum of 4 to 6 weeks to exhibit therapeutic effects in treating depression. Clients may initially experience side effects, such as nausea or changes in sleep patterns, before noticing any improvement in mood. It's crucial to educate clients about this timeline to manage expectations and encourage adherence to the medication regimen.

B. "I should not take this medicine with grapefruit juice."
This statement is incorrect. While grapefruit juice can affect the metabolism of many medications due to its action on cytochrome P450 enzymes, fluoxetine is not significantly impacted by grapefruit juice. Therefore, clients can consume grapefruit juice without the risk of altering the effectiveness or safety of fluoxetine. Providing accurate dietary information is essential to ensure clients feel confident in their dietary choices while on medication.

C. "I’ll take this medicine with food."
While clients may take fluoxetine with food to help minimize potential gastrointestinal upset, it is not strictly necessary. The medication can be effective whether taken with or without food. This flexibility allows clients to choose the method that works best for their individual tolerance and lifestyle, which can improve adherence and comfort.

D. "I’ll take this medicine first thing in the morning."
This is the correct understanding. Taking fluoxetine in the morning is generally recommended because the medication can cause insomnia or increased alertness in some individuals, particularly when initiated. By taking it in the morning, clients can avoid potential sleep disturbances at night, which is important for maintaining a regular sleep-wake cycle and overall well-being. Additionally, consistent timing can help improve adherence to the treatment plan.

Lithium is a mood stabilizer commonly prescribed for bipolar disorder, but it has a narrow therapeutic index, meaning the difference between a therapeutic dose and a toxic dose is small. Therefore, it's crucial for the client to recognize the signs of lithium toxicity. Here's the rationale for each option:

A. "Vomiting is an indication of toxicity.": This statement is correct. Vomiting is one of the early signs of lithium toxicity and should be reported to the healthcare provider immediately.

B. "I will report any loss of appetite.": While loss of appetite can be a symptom of lithium toxicity, it is not one of the most common or specific signs. Other symptoms, such as vomiting, diarrhea, tremors, and confusion, are more indicative of lithium toxicity.

C. "I will call my provider if I experience any headaches.": Headaches are not typically associated with lithium toxicity. Symptoms such as severe diarrhea, tremors, confusion, and decreased coordination are more indicative of lithium toxicity.

D. "Increased flatulence is an indication of toxicity.": Increased flatulence is not a typical manifestation of lithium toxicity. Symptoms such as gastrointestinal upset, tremors, confusion, and changes in coordination are more common signs of toxicity.