A nurse is teaching a client who has a new prescription for fluoxetine to treat depression. Which of the following statements by the client indicates an understanding of the teaching?

"I should expect to feel better after 24 hours of starting this medication."

"I should not take this medicine with grapefruit juice."

"I’ll take this medicine with food."

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

Answer and Explanation

The Correct Answer is D

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.

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Correct Answer is A

Explanation

A. "I'll be glad when I can stop taking this medicine.": This statement indicates a misunderstanding about phenytoin therapy. Phenytoin is typically a long-term medication used to prevent seizures, and it is not typically discontinued unless under the guidance of a healthcare provider. The nurse should clarify that stopping the medication abruptly can lead to rebound seizures and should emphasize the importance of continuing the medication as prescribed.

B. "I have made an appointment to see my dentist next week.": This statement indicates appropriate understanding, as regular dental check-ups are important for individuals taking phenytoin due to the medication's potential side effect of gingival hyperplasia.

C. "I know that I cannot switch brands of this medication.": This statement demonstrates understanding, as different brands of phenytoin can have variations in bioavailability, which can affect seizure control. It is important for clients to remain consistent with the same brand or formulation unless directed otherwise by their healthcare provider.

D. "I will notify my doctor before taking any other medications.": This statement indicates understanding of the potential for drug interactions with phenytoin, as it is a hepatic enzyme inducer and can affect the metabolism of other medications. Clients should always consult their healthcare provider before taking any new medications or supplements to ensure compatibility with phenytoin therapy.

A. The client drinks 2 liters of liquids daily. B. The client eats 2 to 3 gm of sodium-containing foods daily. C. The client runs 4 miles outdoors every afternoon. D. The client eats foods high in tyramine.

Correct Answer is C

Explanation

A. The client drinks 2 liters of liquids daily. - This statement indicates adequate fluid intake, which is important for preventing dehydration and lithium toxicity. Increased fluid intake helps maintain normal lithium levels by promoting its excretion through urine.

B. The client eats 2 to 3 gm of sodium-containing foods daily. - This statement suggests a moderate sodium intake, which can help maintain stable lithium levels. Adequate sodium intake is important for preventing lithium toxicity because sodium depletion can increase lithium reabsorption by the kidneys, leading to higher serum levels.

C. The client runs 4 miles outdoors every afternoon. - This statement indicates excessive sweating, which can lead to dehydration and subsequent lithium toxicity. Vigorous exercise, particularly in hot environments, increases fluid loss through sweating, potentially reducing lithium excretion and increasing serum levels.

D. The client eats foods high in tyramine. - This statement is unrelated to lithium toxicity. Tyramine-containing foods are typically associated with interactions with monoamine oxidase inhibitors (MAOIs), not lithium.

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A nurse is teaching a client who has a new prescription for fluoxetine to treat depression. Which of the following statements by the client indicates an understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is A

Explanation

A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity?

Correct Answer is C

Explanation

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