A nurse is teaching an older adult client about safe medication administration. Which statement by the client indicates a need for further teaching?

"I'll report any new confusion, dizziness, or unsteady gait that occurs after starting a new medication."

“I’ll avoid abruptly stopping any medication, even if I start to feel better."

"Because my metabolism has slowed down, it might take longer for medications to start working, so I can take another dose if I don't feel better."

"Since my kidneys don't clear drugs as efficiently, I should avoid taking over-the-counter medications unless approved by my provider."

Answer and Explanation

The Correct Answer is C

A. "I'll report any new confusion, dizziness, or unsteady gait that occurs after starting a new medication.": Older adults are more susceptible to central nervous system effects due to altered pharmacokinetics and increased blood-brain barrier permeability. Symptoms such as confusion, dizziness, or gait instability increase fall risk and may indicate drug accumulation or sensitivity.

B. “I’ll avoid abruptly stopping any medication, even if I start to feel better.": Abrupt discontinuation of certain medications, such as beta-blockers, benzodiazepines, or antidepressants, can result in rebound effects or withdrawal symptoms. Gradual tapering is often required to maintain physiologic stability.

C. "Because my metabolism has slowed down, it might take longer for medications to start working, so I can take another dose if I don't feel better.": Age-related reductions in hepatic metabolism and renal clearance increase the risk of drug accumulation and toxicity. Taking an extra dose without provider guidance can lead to supratherapeutic levels and adverse effects.

D. "Since my kidneys don't clear drugs as efficiently, I should avoid taking over-the-counter medications unless approved by my provider.": Renal function often declines with age, reducing drug clearance and increasing susceptibility to toxicity. Many over-the-counter medications, including NSAIDs and antihistamines, can impair renal function or interact with prescribed therapies.

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Correct Answer is B

Explanation

A. The client reports dry mouth and mild insomnia: These are common, mild side effects of selective serotonin reuptake inhibitors (SSRIs) like fluoxetine. They are generally self-limiting and manageable with supportive care or lifestyle modifications.

B. The client reports new-onset agitation and thoughts of self-harm: New or worsening suicidal ideation, particularly during the first few weeks of SSRI therapy, is a critical safety concern. Increased energy from improved depressive symptoms can sometimes enable clients to act on existing suicidal thoughts. Immediate reporting to the provider is essential for risk assessment and intervention.

C. The client reports improved energy and appetite: These findings indicate therapeutic improvement and response to treatment. They do not represent an adverse event and would not require urgent intervention.

D. The client reports nausea and headache during the first week: Mild gastrointestinal or neurological side effects are common early in SSRI therapy. These symptoms typically resolve within days to weeks and are monitored but do not necessitate immediate reporting unless they worsen significantly.

Correct Answer is ["56.8"]

Explanation

Calculation:

Identify the client’s weight in pounds

Weight: 125 lbs

Convert pounds to kilograms

1 kg = 2.2 lbs

Weight in kg = 125 ÷ 2.2

= 56.818 kg

Round to one decimal place

= 56.8 kg

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A nurse is teaching an older adult client about safe medication administration. Which statement by the client indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has been prescribed fluoxetine for major depressive disorder. Which finding should the nurse recognize as a priority to report to the provider?

Correct Answer is B

Explanation

A nurse is preparing to administer a medication to a client. The prescribed dose is 0.05 mg/kg. The client weighs 125 pounds. How many kilograms does the client weigh?

Correct Answer is ["56.8"]

Explanation

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