An older client who has type 2 diabetes mellitus (DM) and a history of heart failure (HF) tells the home health nurse that his daughter brought him melatonin to help with sleeping problems. Which information should the nurse provide to the client? Select all that apply.

The body builds up a tolerance of melatonin, requiring higher doses to get therapeutic benefits.

Tell the daughter to check with the healthcare provider before providing herbal supplements,

Remind the daughter that all herbal supplements will not be helpful given the condition of the client.

Remind the client that herbal medications are not regulated by the Food and Drug Administration.

Explain that melatonin can interfere with the action of prescribed medications for DM and HF.

Answer and Explanation

Correct Answer : B,D,E

A. The body builds up a tolerance of melatonin, requiring higher doses to get therapeutic benefits: Tolerance to melatonin is not a typical phenomenon. Melatonin acts on circadian rhythms rather than through receptor pathways that lead to tolerance, so increasing doses over time is not standard or necessary for effectiveness.

B. Tell the daughter to check with the healthcare provider before providing herbal supplements: It is essential to involve the healthcare provider before starting any herbal supplement, especially for clients with complex conditions like diabetes and heart failure, to prevent interactions or exacerbations of existing diseases.

C. Remind the daughter that all herbal supplements will not be helpful given the condition of the client: While some herbal supplements may be inappropriate, it is not accurate to state that all herbal remedies are unhelpful. Each supplement must be evaluated individually based on the client’s medical conditions and medications.

D. Remind the client that herbal medications are not regulated by the Food and Drug Administration: Herbal products like melatonin are classified as dietary supplements and are not strictly regulated by the FDA for quality, consistency, or efficacy, posing a risk for variability in potency and purity.

E. Explain that melatonin can interfere with the action of prescribed medications for DM and HF: Melatonin has the potential to interfere with glycemic control and may also influence blood pressure regulation, complicating the management of diabetes and heart failure. This interaction risk should be discussed with the client.

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Correct Answer is C

Explanation

A. Reassure the client that the patch will begin to take effect within a few minutes: Transdermal nitroglycerin provides a slow, continuous release of medication and is not designed to treat acute chest pain. Relying on the patch alone could delay urgently needed relief for ischemic pain.

B. Withhold further doses of nitroglycerin until contacting the healthcare provider: Sublingual nitroglycerin is prescribed specifically for immediate relief of anginal pain. Waiting for provider instructions before addressing active chest pain would not follow standard angina protocols and could endanger the client.

C. Leave the patch in place and administer a PRN dose of sublingual nitroglycerin: In cases of acute chest pain, it is appropriate to maintain the transdermal patch for background therapy and give sublingual nitroglycerin for immediate relief. Sublingual forms act rapidly by dilating coronary arteries and improving blood flow to relieve ischemia.

D. Obtain another transdermal patch and position it on the client's left upper chest: Applying an additional transdermal patch is inappropriate and could result in overdose, severe hypotension and will not provide immediate relief. The onset of action for transdermal nitroglycerin is too slow to address acute chest pain. The focus should be on a rapid-acting form of nitroglycerin.

A. Positive stool antigen test. B. Reduced epigastric pain. C. Decreased in nighttime awakenings. D. Loss of 3 pounds (1.36 kg) in a month.

Correct Answer is B

Explanation

A. Positive stool antigen test: A positive stool antigen test typically indicates the presence of infection with Helicobacter pylori, which is associated with peptic ulcer disease. Famotidine, a H2 receptor antagonist, reduces gastric acid secretion but does not directly eradicate H. pylori, so this test result is unrelated to its effectiveness.

B. Reduced epigastric pain: Famotidine works by decreasing stomach acid production, promoting healing of ulcers and reducing gastric irritation. Relief of epigastric pain is a primary indicator that the medication is effectively managing acid-related disorders like peptic ulcers or GERD.

C. Decreased in nighttime awakenings: Although reduced nighttime symptoms may occur with effective GERD management, nighttime awakenings can be influenced by many factors. It is a less direct and reliable measure of famotidine's therapeutic action compared to symptom relief from epigastric pain.

D. Loss of 3 pounds (1.36 kg) in a month: Weight loss is not a direct therapeutic effect of famotidine. It could be related to various factors, including improved appetite due to reduced gastrointestinal discomfort, but it doesn't specifically indicate that the famotidine is effectively reducing acid secretion.

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An older client who has type 2 diabetes mellitus (DM) and a history of heart failure (HF) tells the home health nurse that his daughter brought him melatonin to help with sleeping problems. Which information should the nurse provide to the client? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?

Correct Answer is C

Explanation

A client receives a prescription for IV famotidine. Which finding indicates to the nurse the medication is effective?

Correct Answer is B

Explanation

Patient Data Which other medications might be helpful for this client in his management of asthma? Select all that apply.

An older client who has type 2 diabetes mellitus (DM) and a history of heart failure (HF) tells the home health nurse that his daughter brought him melatonin to help with sleeping problems. Which information should the nurse provide to the client? Select all that apply.

Which assessment finding indicates to the nurse that the prescription bethanechol is effective for a client diagnosed with urinary retention?

A client has a prescription for clopidogrel bisulfate 75 mg by mouth daily at 0900. In which situation should the nurse hold this medication?

The nurse is planning to administer sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care?

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