A patient reports insomnia and is prescribed a non-benzodiazepine hypnotic.
Which of the following is an important teaching point?
Take the medication with a large meal.
This medication can be taken during the day.
Avoid activities that require full alertness after taking this medication.
You can increase the dose if sleep is not adequate.
The Correct Answer is C
Choice A rationale
Taking a hypnotic medication with a large meal can delay the absorption and onset of action. For effective treatment of insomnia, these medications should be taken on an empty stomach or with a light snack to ensure rapid absorption and to help the patient fall asleep quickly as intended.
Choice B rationale
Non-benzodiazepine hypnotics are specifically formulated for sleep induction and maintenance. They have a sedative effect and should not be taken during the day, as this would impair daily functioning, alertness, and coordination, posing a significant safety risk to the patient and others.
Choice C rationale
Non-benzodiazepine hypnotics cause sedation, dizziness, and impaired coordination. Patients should be warned to avoid activities that require full alertness, such as driving or operating heavy machinery, after taking the medication to prevent accidents and injuries.
Choice D rationale
Patients should never increase the dose of a prescribed medication without consulting their healthcare provider. Increasing the dose of a hypnotic can lead to increased sedation, potential for overdose, and dependency. The provider needs to assess the patient's response and make any necessary adjustments to the treatment plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Blood glucose levels are not a primary concern for patients taking antithyroid drugs, which are used to treat hyperthyroidism. While thyroid dysfunction can influence blood glucose, monitoring is not a routine part of antithyroid drug therapy. Blood glucose monitoring is essential for patients with diabetes mellitus, which is a separate endocrine disorder from hyperthyroidism.
Choice B rationale
Antithyroid drugs, such as methimazole and propylthiouracil, can cause a serious and rare adverse effect called agranulocytosis, which is a severe reduction in the number of granulocytes, a type of white blood cell. A complete blood count (CBC) is essential to monitor for this life-threatening condition by checking the white blood cell (WBC) count, particularly the neutrophil count. Normal WBC count is 4.5 to 11.0 × 10³ cells/mcL.
Choice C rationale
Serum calcium levels are primarily monitored in conditions related to parathyroid hormone and calcium metabolism, such as hypoparathyroidism or hyperparathyroidism. Antithyroid medications do not directly affect serum calcium levels. Monitoring serum calcium is not a routine part of the management of a patient on antithyroid drugs.
Choice D rationale
The lipid profile, which includes cholesterol and triglycerides, is not routinely monitored for patients on antithyroid drugs. While hyperthyroidism can affect lipid metabolism, antithyroid drugs themselves do not have a significant or primary effect on lipid levels that requires routine monitoring.
Choice E rationale
Serum sodium levels are not a primary concern when a patient is taking antithyroid medications. Hyponatremia or hypernatremia can be caused by various other conditions, such as dehydration, kidney disease, or certain diuretics, but it is not a direct or common side effect of antithyroid drugs.
Choice F rationale
Serum potassium levels are not routinely monitored for patients taking antithyroid drugs. Hyperkalemia or hypokalemia can be caused by various other conditions, such as kidney disease or diuretic use, but it is not a primary or common side effect of antithyroid drugs.
Correct Answer is B
Explanation
Choice A rationale
While taking a nitroglycerin tablet is a common treatment for angina, it should not be the first action. The immediate priority is to stop the activity causing the increased myocardial oxygen demand. Continuing to exert oneself can worsen myocardial ischemia and potentially lead to a more severe cardiac event, such as a myocardial infarction.
Choice B rationale
The primary action should be to stop the activity immediately and rest. Mowing the lawn is a strenuous activity that increases the heart's workload and oxygen demand. By stopping and resting, the patient decreases myocardial oxygen consumption, which can help alleviate the chest pain and prevent further myocardial ischemia.
Choice C rationale
While moving inside to cool off and get water may seem helpful, it is not the most critical first step. The immediate need is to reduce the cardiac workload, which is best achieved by ceasing the physical exertion. A patient should first sit or lie down to rest, as this action directly addresses the increased oxygen demand.
Choice D rationale
Calling 911 is crucial if the chest pain does not subside with rest or if it worsens. However, it is not the very first action to take. The initial step is always to stop the activity and rest, as this may be sufficient to resolve the symptoms. If the pain persists after resting, then it is appropriate to seek immediate emergency medical help.
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