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 ["20"]

Explanation

To calculate the dose of midazolam to administer, we need to convert the client's weight from pounds to kilograms, and then multiply by the dose per kilogram.

Given: Client weight = 220 lb

Dose of midazolam = 0.2 mg/kg

First, let's convert the client's weight from pounds to kilograms:

1 lb ≈ 0.453592 kg (approximately 0.45 kg, for simplicity)

Client weight in kilograms ≈ 220 lb × 0.45 kg/lb ≈ 99 kg

Now, let's calculate the dose of midazolam:

Dose = Weight (in kg) × Dose per kg Dose ≈ 99 kg × 0.2 mg/kg = 19.8 mg

Rounded to the nearest whole number, the nurse should administer approximately 20 mg of midazolam.

A. Dystonia B. Tardive dyskinesia C. Parkinsonism D. Akathisia

Correct Answer is B

Explanation

A. Dystonia - Dystonia presents as sustained or intermittent muscle contractions causing abnormal, often repetitive, movements or postures. It is an acute extrapyramidal side effect of antipsychotic medications like chlorpromazine but typically manifests as sudden-onset muscle spasms rather than involuntary movements of the tongue and face.

B. Tardive dyskinesia - Tardive dyskinesia is a late-appearing movement disorder characterized by involuntary, repetitive movements of the face, tongue, and limbs. It is associated with long-term use of antipsychotic medications like chlorpromazine and typically develops after months to years of treatment.

C. Parkinsonism - Parkinsonism resembles Parkinson's disease and is characterized by symptoms such as tremor, rigidity, bradykinesia, and postural instability. While antipsychotic medications can cause Parkinsonism as an adverse effect, it usually presents with symptoms different from those described in the scenario.

D. Akathisia - Akathisia is characterized by an inner feeling of restlessness and the urge to move, often accompanied by pacing and inability to sit still. It is an acute extrapyramidal side effect of antipsychotic medications but does not manifest as involuntary movements of the tongue and face as described in the scenario.

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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 preparing to administer midazolam 0.2 mg/kg via IV bolus now. The client weighs 220 lb. How many mg should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["20"]

Explanation

A nurse is assessing a client who has schizophrenia and has been on long-term treatment with chlorpromazine. He notes the client is experiencing some involuntary movements of the tongue and face. The nurse should suspect the client has developed which of the following adverse effects?

Correct Answer is B

Explanation

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