A nurse is reinforcing teaching for a female client who has multiple sclerosis and a new prescription for dantrolene.
Which of the following client statements indicates an understanding of the teaching?.
"I should take this medication when my spasms are bad.”.
"I need to notify my provider if I don't get some relief from my muscle spasms within 3 months.”.
"I am glad this medication is safe to take if I get pregnant.”.
"I should return to the clinic to have my calcium level checked every 6 weeks.”.
The Correct Answer is B
The correct answer is Choice B
Choice A rationale: Dantrolene is a direct-acting skeletal muscle relaxant that works by inhibiting calcium release from the sarcoplasmic reticulum in muscle cells, thereby reducing muscle contraction. It is not intended for as-needed use during acute spasms but requires consistent dosing to maintain therapeutic levels. Intermittent use undermines its pharmacokinetics and may lead to subtherapeutic effects. The half-life of dantrolene is approximately 8.7 hours, and steady-state levels are necessary for optimal spasticity control in multiple sclerosis.
Choice B rationale: Dantrolene’s therapeutic effect on muscle spasticity may take several weeks to manifest due to its mechanism of action involving gradual reduction in intracellular calcium availability. If no improvement is noted within 3 months, it may indicate inadequate response or the need for dosage adjustment. Monitoring for efficacy is essential, as prolonged use without benefit increases risk of hepatotoxicity. Liver function tests should be monitored regularly. Normal ALT levels are 7–56 units/L; elevations may signal toxicity.
Choice C rationale: Dantrolene is classified as pregnancy category C, indicating that risk to the fetus cannot be ruled out. Animal studies have shown adverse effects, and there are no adequate human studies confirming safety during pregnancy. Therefore, it is not considered safe without careful risk-benefit analysis. Teratogenicity and fetal toxicity are concerns due to its action on muscle fibers and potential systemic effects. Pregnant clients should consult their provider before initiating or continuing dantrolene therapy.
Choice D rationale: Dantrolene does not directly affect calcium levels in the bloodstream. Its mechanism involves inhibition of calcium release within muscle cells, not systemic calcium metabolism. Routine calcium monitoring is not required unless the client has a separate condition affecting calcium homeostasis. Normal serum calcium levels range from 8.5 to 10.5 mg/dL. The primary lab concern with dantrolene is hepatotoxicity, necessitating regular liver function tests, not calcium surveillance. This statement reflects a misunderstanding of the drug’s effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C. Apply gentle pressure with a finger to the tragus of the ear.
Choice A rationale:
Chilling the medication prior to administration is not recommended. Cold ear drops can cause dizziness or discomfort when instilled into the ear. It is generally advised to warm the drops to body temperature by holding the bottle in your hands for a few minutes before administration.
Choice B rationale:
Holding the dropper against the ear canal while instilling the medication is incorrect. The dropper should be held above the ear canal to avoid contamination and injury. Touching the dropper to the ear canal can introduce bacteria and cause infection.
Choice C rationale:
Applying gentle pressure with a finger to the tragus of the ear helps to facilitate the flow of the medication into the ear canal. This action helps to ensure that the medication reaches the affected area effectively.
Choice D rationale:
Straightening the external auditory canal by pulling it down and back is incorrect for adults. For adults, the correct method is to pull the ear up and back to straighten the ear canal. Pulling it down and back is the method used for children.
Correct Answer is ["10"]
Explanation
Step 1 is to calculate the amount of hydroxyzine HCL in each mL of the oral suspension. This is done by dividing the total amount of hydroxyzine HCL (25 mg) by the total volume (5 mL), which gives us 5 mg/mL. Step 2 is to calculate the volume of oral suspension that contains 50 mg of hydroxyzine HCL. This is done by dividing the prescribed dose (50 mg) by the concentration of the oral suspension (5 mg/mL). So, 50 mg ÷ 5 mg/mL = 10 mL.
So, the correct answer is 10 mL.
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