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 D

Explanation

A. Two hours after completion is too late to accurately capture the peak serum concentration, and drawing a trough two hours before the next dose will result in an artificially elevated trough level, as the drug has not yet cleared to its lowest concentration.

B. One hour after completion may miss the true peak concentration for intravenous vancomycin, and drawing a trough one hour before the next dose does not represent the absolute lowest point of the medication's therapeutic window.

C. Thirty minutes into the infusion is too early to measure a peak because the entire dose has not yet been delivered into the bloodstream, which can lead to inaccurate clinical decision-making.

D. To capture the maximum concentration of the drug in the bloodstream, the peak level should be drawn immediately after completion of the intravenous infusion (or within 30 to 60 minutes depending on facility protocol and infusion duration). To capture the lowest concentration, the trough level must be drawn immediately prior to the next scheduled dose, typically 30 minutes before administration.

A. Scratchy throat. B. Pupillary constriction. C. Hypertension. D. Bradycardia. E. None F. None

Correct Answer is A

Explanation

A. A scratchy throat can be an early sign of an allergic reaction to the antibiotic, which could progress to anaphylaxis if the infusion continues. Immediate cessation of the infusion is essential to prevent serious complications, and the nurse should notify the provider and initiate emergency interventions if needed.

B. Pupillary constriction is not a typical sign of an acute allergic reaction to piperacillin-tazobactam and does not warrant stopping the infusion.

C. Hypertension is not an expected early manifestation of an allergic reaction to this antibiotic. Blood pressure changes are more likely to occur later if anaphylaxis develops.

D. Bradycardia is not commonly associated with an early allergic reaction to antibiotics and does not require immediate cessation of the infusion unless other signs of anaphylaxis are present.

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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

A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

Correct Answer is D

Explanation

The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion?

Correct Answer is A

Explanation

The nurse prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's vital signs are temperature 99° F (37.2° C), heart rate 48 beats/minute, respirations 16 breaths/minute, and blood pressure (B/P) 150/90 mm Hg. Which action should the nurse take?

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