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 A

Explanation

A. Elective surgery is scheduled in two hours: Clopidogrel is an antiplatelet agent that significantly increases the risk of bleeding. It should be held prior to surgery to minimize intraoperative and postoperative bleeding risks. Surgeons often require clopidogrel to be discontinued several days in advance, making it critical to withhold the drug if surgery is imminent.

B. An abdominal sonogram is scheduled: An abdominal ultrasound is a noninvasive imaging test that does not carry bleeding risks. There is no need to hold clopidogrel prior to sonogram procedures because it does not impact the safety or accuracy of the imaging study.

C. Breakfast has not been eaten: Clopidogrel can be taken with or without food. Skipping a meal does not contraindicate administering the medication, although taking it with food can sometimes help reduce gastrointestinal discomfort.

D. The client's platelet level is high: Clopidogrel works by inhibiting platelet aggregation, not by lowering platelet count. A high platelet count alone is not a reason to withhold the medication unless there is a specific bleeding risk or another contraindication identified by the healthcare provider.

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

Correct Answer is A

Explanation

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

Correct Answer is B

Explanation

A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?

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A client with eczema receives a prescription for betamethasone cream. Which client statement indicates to the nurse that further teaching is needed?

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