A nurse is providing teaching for a client who has a new prescription for alprazolam to treat insomnia. Which of the following instructions should the nurse include?

"Avoid activities that require alertness, such as driving."

"Monitor for peripheral edema."

"Take this medication with a high-fat meal."

"Take this medication every night before sleep."

Answer and Explanation

The Correct Answer is A

Alprazolam is a benzodiazepine medication commonly used to treat anxiety and insomnia. Here's the rationale for each option:

A. "Avoid activities that require alertness, such as driving.": Alprazolam can cause drowsiness and impair cognitive function, so it's essential for clients to avoid activities that require alertness, such as driving or operating heavy machinery, while taking this medication. Providing this instruction promotes safety and prevents accidents.

B. "Monitor for peripheral edema.": Peripheral edema is not a common side effect of alprazolam. This instruction is not relevant to the use of this medication.

C. "Take this medication with a high-fat meal.": Alprazolam can be taken with or without food, but taking it with a high-fat meal may delay its absorption. Therefore, it is not necessary to instruct the client to take it with a high-fat meal, especially since this may affect the medication's effectiveness.

D. "Take this medication every night before sleep.": While alprazolam may be used to treat insomnia, it is not typically recommended for nightly use due to the risk of dependence and tolerance. Using it nightly can lead to addiction and withdrawal symptoms if abruptly stopped. Therefore, this instruction is not appropriate.

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Correct Answer is C

Explanation

A. Speaking to the provider about adding an MAOI to the current medication regimen: MAOIs (Monoamine oxidase inhibitors) are typically considered as second- or third-line treatments due to their potential for serious side effects and interactions with other medications. It is not the first-line approach to managing depressive symptoms that have not improved with citalopram alone.

B. Telling the client that the provider will need to change citalopram to a different medication: It's premature to switch medications after only two weeks, as antidepressants often take several weeks to exert their full therapeutic effect. It's essential to allow adequate time for the current medication regimen to work before considering a change.

C. Explaining that antidepressants often take several weeks to be fully effective: This is the most appropriate action. It's important for the nurse to educate the client about the delayed onset of action of antidepressants and reassure them that improvement may take time. Adjustments to the dosage or switching to a different medication would typically be considered if there is no improvement after a sufficient trial period.

D. Recommending a sleep study be done on the client: While sleep disturbances are common in depression, recommending a sleep study would be premature at this stage. It's essential to address the underlying depressive symptoms first, as they may contribute to the sleep disturbance.

A. Dilute the medication with sterile water before injecting. B. Administer the medication over 1 min. C. Slow the injection if the medication crystallizes. D. Follow the IV injection with sterile water.

Correct Answer is B

Explanation

A. Dilute the medication with sterile water before injecting: Phenytoin should not be diluted before administration because it may cause precipitation or crystallization of the drug, leading to potential adverse effects such as tissue irritation or embolism.

B. Administer the medication over 1 min: Phenytoin should be administered slowly over 1 to 2 minutes to reduce the risk of adverse effects such as hypotension or cardiac arrhythmias. Rapid infusion can lead to cardiovascular collapse.

C. Slow the injection if the medication crystallizes: If the medication crystallizes, the nurse should stop the injection immediately and flush the IV line with normal saline. However, preventing crystallization by administering the medication slowly over the recommended time is preferable.

D. Follow the IV injection with sterile water: Following the IV injection with sterile water is not a standard practice for administering phenytoin. Instead, the nurse should follow institutional guidelines for flushing the IV line after medication administration, typically with normal saline.

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A nurse is providing teaching for a client who has a new prescription for alprazolam to treat insomnia. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A nurse is preparing to administer phenytoin 50 mg IV bolus to a client who has a seizure disorder. The medication is supplied as a 50 mg/mL vial Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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