A female client starts a new prescription, oxybutynin, for symptoms of an overactive bladder. The client tells the nurse that she is training to run in a half-marathon. Which instruction should the nurse emphasize?

Keep skin and eyes covered to protect from sun injury.

Avoid crowds to help prevent acquiring infections.

Wear padding to protect from bruising if a fall occurs.

Take measures to avoid dehydration and overheating.

Answer and Explanation

The Correct Answer is D

Choice A Reason:

While keeping skin and eyes covered to protect from sun injury is generally good advice, it is not specifically related to the use of oxybutynin. Oxybutynin can reduce sweating, which increases the risk of overheating and dehydration, especially during physical activities like running a half-marathon. Therefore, this advice, while useful, is not the most critical in this context.

Choice B Reason:

Avoiding crowds to help prevent acquiring infections is important for overall health, especially for individuals with compromised immune systems. However, this advice is not directly related to the use of oxybutynin or the specific risks associated with its use during physical exercise. The primary concern with oxybutynin is its effect on sweating and body temperature regulation.

Choice C Reason:

Wearing padding to protect from bruising if a fall occurs is a precaution that might be relevant for individuals at risk of falls or injuries. However, this advice does not address the specific risks associated with oxybutynin use during physical exercise. The main concern is the potential for overheating and dehydration due to reduced sweating.

Choice D Reason:

Taking measures to avoid dehydration and overheating is the most critical instruction for a client using oxybutynin while training for a half-marathon. Oxybutynin can decrease sweating, making it harder for the body to cool down during exercise. This can lead to heat stroke or severe dehydration. The nurse should emphasize the importance of staying hydrated, taking breaks, and avoiding excessive heat to prevent these serious complications.

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Correct Answer is B

Explanation

Choice A Reason:

While monitoring temperature is important for overall health assessment, it is not the most critical vital sign to check first in the context of opioid-induced lethargy. Opioids primarily affect the respiratory system, and respiratory depression is a significant risk. Therefore, temperature is not the priority in this scenario.

Choice B Reason:

Respiratory rate is the most critical vital sign to check first. Opioids can cause respiratory depression, which can be life-threatening. A decreased respiratory rate is a key indicator of opioid overdose or severe side effects. Monitoring the respiratory rate allows the nurse to assess the severity of the respiratory depression and take immediate action if necessary.

Choice C Reason:

Pulse rate is also an important vital sign, but it is secondary to respiratory rate in this context. While opioids can affect heart rate, the immediate concern with opioid-induced lethargy is respiratory depression. Therefore, checking the respiratory rate takes precedence over the pulse rate.

Choice D Reason:

Blood pressure is another vital sign that should be monitored, but it is not the first priority in this situation. Opioids can cause hypotension, but the primary and most immediate concern is respiratory depression. Therefore, the respiratory rate should be assessed first to ensure the client’s airway and breathing are adequate.

A. Rinsing the mouth with water should be done after each use. B. To mask the taste of the medication, the inhaler can be used during meals. C. Caffeinated beverages should be limited to two cups per day. D. The inhaler will be used before bed at night.

Correct Answer is A

Explanation

Choice A reason:

Rinsing the mouth with water after using an inhaler, especially one containing corticosteroids, is crucial to prevent oral thrush (a fungal infection) and reduce irritation in the mouth and throat. This practice helps maintain oral hygiene and ensures the medication does not linger in the mouth, which can cause side effects.

Choice B reason:

Using the inhaler during meals to mask the taste of the medication is not recommended. Inhalers should be used as prescribed, and the technique should not be altered to mask the taste. Proper inhaler technique is essential for the medication to reach the lungs effectively.

Choice C reason:

Limiting caffeinated beverages to two cups per day is generally good advice for overall health, but it is not directly related to the use of an inhaler. Caffeine can sometimes exacerbate symptoms of asthma or other respiratory conditions, but this is not a primary instruction for inhaler use.

Choice D reason:

Using the inhaler before bed at night may be part of a prescribed regimen, but it is not a general instruction that indicates understanding of inhaler use. The timing of inhaler use should follow the healthcare provider’s instructions, which may vary depending on the medication and the individual’s condition.

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A female client starts a new prescription, oxybutynin, for symptoms of an overactive bladder. The client tells the nurse that she is training to run in a half-marathon. Which instruction should the nurse emphasize?

Nursing Test Bank

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