The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

Family history of mental illness

Weight change in the last month.

Liver function laboratory results.

Recent use of other antidepressants.

Answer and Explanation

The Correct Answer is C

Choice A rationale; Family history of mental illness is important information to consider when assessing the client's overall mental health history, but it is not directly related to the immediate safety and effectiveness of duloxetine.

Choice B rationale: Weight change in the last month is relevant to monitoring for side effects of duloxetine, but it is not as critical as assessing liver function, which directly impacts the metabolism of the medication.

Choice C rationale: When planning care for a client starting on duloxetine, it is most important for the nurse to obtain liver function laboratory results. Duloxetine is primarily metabolized in the liver, and it is important to assess the client's liver function before starting the medication to ensure that the liver can process the drug effectively and safely. Clients with impaired liver function may require dose adjustments or be at higher risk for adverse effects, so obtaining liver function test results is crucial for safe medication management.

Choice D rationale: Recent use of other antidepressants is essential to avoid potential drug interactions, but it is not the most critical piece of information compared to assessing liver function, which directly affects the client's ability to process duloxetine.

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Correct Answer is C

Explanation

A. Bedtime is the best time to take the tablet.While taking medication at bedtime can sometimes be convenient, it is not necessarily the best time for iron absorption. Iron is best absorbed on an empty stomach, and bedtime might not always align with this condition.

B. Crush the tablets and mix with pudding.Crushing enteric-coated tablets is not recommended because it destroys the coating designed to protect the stomach lining from irritation and to ensure the iron is released in the intestine where it is best absorbed.

C. Wait 2 hours after meals to take the tablet.This is the correct answer because iron is best absorbed on an empty stomach, typically one hour before or two hours after meals. Food can interfere with the absorption of iron, so waiting ensures better efficacy of the supplement.

D. Take the tablet with a daily multivitamin.Taking iron with a multivitamin can be problematic because certain minerals in multivitamins, such as calcium, can inhibit iron absorption. It is better to take iron supplements separately to maximize absorption.

A. Ingestion of Wort can reduce the client's intake of sodium. B. Adding the herb decrease the need for corticosteroids. C. The client probably used this herb to treat depression. D. Wort can decrease plasma concentrations of cyclosporine.

Correct Answer is D

Explanation

Choice A rationale: Ingestion of Wort can reduce the client's intake of sodium: This information is not directly related to the situation of a renal transplant and graft rejection. It is not the most significant finding regarding the use of St. John's Wort in this context.

Choice B rationale: Adding the herb decreases the need for corticosteroids: There is no evidence or indication that St. John's Wort can decrease the need for corticosteroids, especially in the context of a renal transplant and graft rejection.

Choice C rationale: While St. John's Wort is sometimes used as an herbal remedy for depression, the most significant information, in this case, is its potential to interact with cyclosporine and affect the client's immunosuppressive medication. The focus should be on the drug interaction and the risk it poses to the client's graft health, rather than the reason for using the herb.

Choice D rationale: The most significant information about the finding that the client has been self-administering St. John's Wort is that it can decrease plasma concentrations of cyclosporine. Cyclosporine is an immunosuppressive medication commonly used after a renal transplant to prevent graft rejection. When St. John's Wort is taken concurrently with cyclosporine, it can induce certain liver enzymes responsible for drug metabolism, leading to a decreased concentration of cyclosporine in the bloodstream. This can potentially reduce the effectiveness of cyclosporine in preventing graft rejection, putting the client's transplanted kidney at risk.

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The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets. To promote best absorption of the medication, which information should the nurse include in the discharge instructions?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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