A nurse is providing teaching to a client who has depressive disorder and a new prescription for doxepin. Which of the following instructions should the nurse include in the teaching?
Avoid over-the-counter magnesium when taking this medication
Eat a snack before going to bed.
Sit on the side of the bed for a few minutes before standing
Decrease the prescribed dose by half when mood improves
The Correct Answer is C
A. Avoid over-the-counter magnesium when taking this medication: There is no specific contraindication between doxepin and magnesium supplements. However, clients should consult their healthcare provider before using any over-the-counter products.
B. Eat a snack before going to bed: While this is not incorrect for some medications, it is not a primary teaching point for doxepin. The medication's primary side effect concerns are sedation and orthostatic hypotension, not hunger-related issues.
C. Sit on the side of the bed for a few minutes before standing: Doxepin, a tricyclic antidepressant, can cause orthostatic hypotension, leading to dizziness when standing. Sitting on the side of the bed before standing helps reduce this risk by allowing the body to adjust to the change in position.
D. Decrease the prescribed dose by half when mood improves: Clients should never adjust their prescribed medication dose without consulting their provider. Abruptly stopping or reducing the dose can cause withdrawal symptoms or a relapse of depressive symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Schedule the client for a morning group fitness class at the facility: Regular morning exercise promotes healthy sleep patterns by helping regulate the body's circadian rhythm. Engaging in physical activity early in the day can reduce restlessness at night.
B. Limit the client to no more than four caffeinated beverages a day: While caffeine should be limited, the most effective approach is to avoid caffeine entirely in the afternoon and evening to prevent sleep disruption, rather than just limiting it to four beverages a day.
C. Walk around the hallway with the client an hour before bedtime: Although light physical activity can promote sleep, intense exercise or walking too close to bedtime can sometimes increase alertness and make it harder for the client to fall asleep.
D. Allow the client several hours in the afternoon to take a nap: Long naps, especially in the afternoon, can disrupt the client's sleep cycle and make it more difficult for them to fall asleep at night. Limiting naps during the day is typically more helpful.
Complete the following sentence by using the lists of options.
The client is at risk of developing
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}
Explanation
Rationale for correct choices:
- Alcohol withdrawal syndrome: The client’s BAC of 310 mg/dL indicates severe intoxication. As the alcohol clears from the system, withdrawal symptoms such as anxiety, tremors, and seizures may occur, requiring close monitoring to prevent complications like delirium tremens.
- Blood alcohol level of 310 mg/dL: This elevated BAC indicates significant alcohol consumption. As the alcohol is metabolized, the client is at high risk for alcohol withdrawal syndrome and requires close observation to manage withdrawal symptoms as the BAC decreases.
Rationale for incorrect choices:
- Malnutrition: While weight loss and minimal appetite may be concerning, they do not definitively indicate malnutrition. These symptoms are more likely tied to the client’s psychological distress and alcohol use rather than severe nutritional deficiency.
- Alcohol intoxication: The client’s current state is intoxicated; the primary concern at this stage is managing alcohol withdrawal syndrome. Once the alcohol is metabolized, the focus will shift to preventing withdrawal complications which the client is at risk of.
- Respiratory rate of 10/min: A respiratory rate of 10/min is on the low side but not dangerously low. This rate may be associated with alcohol intoxication and will require monitoring but is not immediately alarming unless the client shows signs of respiratory distress.
- Weight loss over the past 3 months and minimal appetite: The weight loss and reduced appetite are concerning but not immediately indicative of malnutrition. These symptoms are likely due to the client’s alcohol use and emotional distress, and further assessment is needed to evaluate nutritional health.
