A nurse is reinforcing teaching with a client who started taking haloperidol decanoate 125 mg IM 1 month ago.
Which of the following statements by the client should the nurse address?.
"I check my blood pressure once a week.”.
"I chew sugar-free gum several times daily.”.
"I haven't had a drink of alcohol since I started taking these injections.”.
"I spend several hours a day outside gardening when it's sunny.”. .
The Correct Answer is D
Choice A rationale:
Checking blood pressure once a week is a good practice, especially for clients on medications that can affect blood pressure.
Choice B rationale:
Chewing sugar-free gum several times daily is not harmful and can help with dry mouth, a common side effect of haloperidol.
Choice C rationale:
Avoiding alcohol while taking haloperidol is recommended as alcohol can increase the side effects of the medication.
Choice D rationale:
Spending several hours a day outside gardening when it’s sunny can lead to a condition called photosensitivity, a side effect of haloperidol. The client should be advised to wear protective clothing and sunscreen when outside.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Documenting the client’s behavior every hour is not necessary. The nurse should monitor and document the client’s condition, but this does not need to be done every hour.
Choice B rationale:
Providing range-of-motion exercises to all extremities every 2 hours is important when a client is in restraints. This helps to prevent muscle stiffness and maintain circulation.
Choice C rationale:
The provider does not need to renew the prescription every 24 hours. The use of restraints should be reassessed regularly, but a new prescription is not required unless the restraints are removed and then need to be reapplied.
Choice D rationale:
Keeping staff interactions with the client to a minimum is not recommended. The client should be monitored closely and regular interaction can help to calm the client and reduce the need for restraints.
Correct Answer is D
Explanation
Choice A rationale:
Teaching sessions right before bedtime may not be effective as older adults may be tired and less able to concentrate.
Choice B rationale:
Establishing long-term goals can be overwhelming for older adults. Short-term goals are more manageable and achievable.
Choice C rationale:
Long teaching sessions may lead to fatigue and decreased concentration. Short, frequent sessions are more effective.
Choice D rationale:
Using “I” statements rather than “you” statements can help create a more positive and collaborative learning environment.
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