A nurse is reinforcing teaching with a client who has schizophrenia and a new prescription for haloperidol. The nurse should instruct the client to avoid taking which of the following medications?

Diphenhydramine

Docusate sodium

Ibuprofen

Glucosamine

Answer and Explanation

The Correct Answer is A

A. Diphenhydramine. Diphenhydramine is a first-generation antihistamine with anticholinergic properties that can increase the risk of central nervous system (CNS) depression when taken with haloperidol. Both drugs can cause sedation, confusion, and impaired coordination, increasing the risk of falls and other complications. Additionally, combining them can worsen extrapyramidal symptoms (EPS) or lead to anticholinergic toxicity, making it an unsafe combination.

B. Docusate sodium. Docusate sodium is a stool softener used to prevent constipation. Haloperidol can cause constipation as a side effect due to its anticholinergic properties, so docusate sodium is safe and may even be beneficial in preventing bowel complications.

C. Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation. While it does not have a direct interaction with haloperidol, it should be used with caution in clients with a history of gastrointestinal issues or kidney disease. However, it does not pose a significant risk when taken alongside haloperidol.

D. Glucosamine. Glucosamine is a dietary supplement used to support joint health. It does not interact with haloperidol and does not have sedative or CNS effects. Clients taking haloperidol can safely use glucosamine if needed.

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Correct Answer is C

Explanation

A. "My appetite is increased." Diphenhydramine is an antihistamine that primarily treats allergic reactions by blocking histamine receptors. While antihistamines can sometimes cause increased appetite as a side effect, this is not an indicator of effectiveness in treating an allergic reaction.

B. "I don't have a headache anymore." While diphenhydramine may help with headaches due to its sedative and antihistamine effects, headache relief is not the primary goal when treating an allergic reaction. The effectiveness of diphenhydramine in this scenario should be assessed based on improvements in allergic symptoms rather than headache relief.

C. "My voice is no longer hoarse." Hoarseness can be a sign of airway involvement due to allergic reaction-related swelling (laryngeal edema). Diphenhydramine reduces histamine-induced inflammation, which can help resolve airway symptoms. Improvement in hoarseness suggests reduced swelling and a lower risk of airway obstruction, making this the best indicator of effectiveness.

D. "I am feeling more alert." Diphenhydramine commonly causes drowsiness due to its sedative effects. Feeling more alert would be an unusual response to the medication and does not indicate improvement in the allergic reaction. The primary concern is symptom resolution, particularly respiratory symptoms, rather than changes in alertness.

A. Excoriation B. Firmness C. Ulceration D. Bleeding

Correct Answer is B

Explanation

A. Excoriation. Excoriation (skin abrasion or scratching) does not indicate a positive tuberculin skin test. A positive reaction is determined by induration (firm swelling) rather than skin irritation or superficial damage. Scratching the site can cause redness, but this is not a diagnostic sign of tuberculosis exposure.

B. Firmness. A positive tuberculin skin test is identified by the presence of induration (firm, raised swelling) at the injection site, which is measured in millimeters. The size of induration considered positive depends on the client’s risk factors. For example, ≥5 mm is positive in immunocompromised individuals, ≥10 mm in high-risk populations, and ≥15 mm in individuals with no risk factors.

C. Ulceration. Ulceration is not a typical reaction to a tuberculin skin test. If ulceration occurs, it may indicate improper injection technique, irritation, or an allergic reaction, rather than a true positive result. The test should be repeated in such cases.

D. Bleeding. Minor pinpoint bleeding at the injection site may occur due to the needle puncture but does not indicate a positive result. The key indicator of a positive test is the presence of measurable induration, not redness, bruising, or bleeding.

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A nurse is reinforcing teaching with a client who has schizophrenia and a new prescription for haloperidol. The nurse should instruct the client to avoid taking which of the following medications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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