The nurse is providing discharge instructions for a client with metastatic cancer who is prescribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

Observe bowel movement pattern and take a stool softener.

Do not drink grapefruit juice after taking morphine.

Watch for signs of agitation and record any insomnia.

Take the benzodiazepine at the same time of taking the morphine.

Answer and Explanation

The Correct Answer is A

A. Observe bowel movement pattern and take a stool softener: Morphine commonly causes constipation due to reduced gastrointestinal motility. Recognizing this and taking preventive measures like a stool softener indicates a good understanding of how to manage one of the most frequent and bothersome side effects of opioid therapy.

B. Do not drink grapefruit juice after taking morphine: Grapefruit juice significantly interacts with certain medications, particularly those metabolized by CYP3A4 enzymes, but it has minimal clinical effect on morphine metabolism. This instruction is not relevant for morphine use.

C. Watch for signs of agitation and record any insomnia: While these symptoms can occasionally occur, they are not typical or expected side effects of morphine. More common effects include sedation, respiratory depression, and constipation.

D. Take the benzodiazepine at the same time of taking the morphine: Combining morphine with benzodiazepines increases the risk of severe sedation, respiratory depression, and overdose. Co-administration should be carefully managed and typically avoided unless specifically directed by the healthcare provider.

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Correct Answer is B

Explanation

A. Administer an oral analgesic and evaluate its effectiveness before applying the new patch: There is no need to switch to oral analgesics if the client is already well-managed on a fentanyl patch. The focus should be on properly managing the patch schedule rather than changing the route of administration.

B. Apply the new patch in a different location after removing the original patch: Proper protocol for transdermal patches includes removing the old patch before applying a new one to prevent overdose. The new patch should be placed on a different skin site to avoid skin irritation and ensure even drug absorption.

C. Place the patch on the client's shoulder and leave both patches in place for 12 hours: Leaving both patches in place can lead to dangerously high serum fentanyl levels and significant respiratory depression. Only one patch should be used at a time unless otherwise specifically prescribed.

D. Remove the patch and consult with the healthcare provider (HCP) about the client's pain resolution: It is unnecessary to contact the HCP immediately if the client is pain-free and the scheduled time for patch replacement has arrived. Standard procedure should be followed by simply removing the old patch and applying the new one.

A. Describe how anabolic steroids increase muscle strength to improve athletic performance. B. Advise of the need to observe for changes in behavior, such as increased aggression. C. Explain that this is a schedule II controlled substance. D. Encourage a clinic visit to assess the adolescent for cardiovascular complications. E. Identify the use of any other herbal supplements.

Correct Answer is ["B","D","E"]

Explanation

A. Describe how anabolic steroids increase muscle strength to improve athletic performance: While anabolic steroids do enhance muscle mass and strength, emphasizing this could inadvertently normalize or encourage their misuse rather than addressing the serious health risks involved.

B. Advise of the need to observe for changes in behavior, such as increased aggression: Anabolic steroids can cause mood disturbances, including aggression, irritability, and even psychiatric symptoms. Educating the parent to monitor for behavioral changes is critical for early intervention.

C. Explain that this is a schedule II controlled substance: Anabolic steroids are actually classified as Schedule III controlled substances under the Controlled Substances Act, not Schedule II. Providing inaccurate information could lead to confusion and mismanagement of the situation.

D. Encourage a clinic visit to assess the adolescent for cardiovascular complications: Steroid use can increase the risk of serious cardiovascular problems like hypertension, lipid abnormalities, and myocardial damage. Prompt medical evaluation is essential to detect early complications.

E. Identify the use of any other herbal supplements: Adolescents who misuse anabolic steroids may also be using other supplements or substances that could have dangerous interactions. A full assessment of all substances being used is important for comprehensive care and counseling.

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The nurse is providing discharge instructions for a client with metastatic cancer who is prescribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

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Naxlex Comprehensive Predictor Exams

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?

Correct Answer is B

Explanation

The mother of an adolescent male tells the clinic nurse that she found anabolic steroids in her son's room. How should the nurse respond? Select all that apply.

Correct Answer is ["B","D","E"]

Explanation

After receiving five doses of filgrastim, the nurse notes that the client's white blood cell count has increased from 2,500/mm3 (2.5 x 10 /L) to 5,000/mm3 (5 x 105/L). Which action should the nurse implement?Reference Range:White Blood Cell (WBC) [5,000 to 10,000/mm3 (5 to 10 x 109/L)]

Azithromycin is prescribed for a client with Chlamydia trachomatis. In providing client teaching about the medication, the nurse should emphasize the importance of reporting the onset of which symptom to the healthcare provider (HCP)?

The healthcare provider (HCP) prescribes 1 liter of 0.9% sodium chloride, USP IV to be infused over 12 hours for a client. How many mL/hr should the nurse program the infusion pump to deliver? (Enter numerical value only. If rounding is required, round to the nearest whole number.)

A client with postpartum depression receives a prescription for sertraline. Which information is most important for the nurse to include in client teaching?

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Which client's laboratory value should the nurse review prior to administering the initial dose of a statin medication?

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Patient Data Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.