Page 2379 - Saunders Comprehensive Review For NCLEX-RN

Reference: Varcarolis (2017), p. 48, 264.

844. Answer: 4

Rationale: Phenobarbital is an anticonvulsant and hypnotic agent. The client
should avoid taking any other central nervous system depressants such as alcohol
while taking this medication. The medication may be given without regard to meals.
Taking the medication at the same time each day enhances compliance and
maintains more stable blood levels of the medication. Using a dose container or
“pillbox” may be helpful for some clients.
Test-Taking Strategy: Focus on the subject, client safety, and note the strategic
words, highest priority. Eliminate option 1 because of the closed-ended wordonly.
Although options 2 and 3 are correct teaching points, these are not the highest
priority from the options provided. Remember that alcohol should not be consumed
when a hypnotic is taken because of its adverse effects.
Level of Cognitive Ability: Applying
Client Needs: Safe and Effective Care Environment
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Psychotherapeutics: Barbiturate and sedative-
hypnotics
Health Problem: N/A
Priority Concepts: Client Education; Safety
Reference: Hodgson, Kizior (2018), pp. 932-933

845. Answer: 2

Rationale: Amitriptyline causes constipation, and the client is instructed to
increase fluid intake and bulk (high fiber) in the diet. If the heart begins to beat fast,
the primary health care provider (PHCP) is notified, because this could indicate an
adverse effect. Difficulty urinating is an adverse effect and indicates urinary
retention; this should also be reported.
Test-Taking Strategy: Focus on the subject, side and adverse effects of
amitriptyline. Recalling that constipation is a side effect of this medication will direct
you to the correct option.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Psychotherapeutics: Tricyclic antidepressants
Health Problem: Mental Health: Mood Disorders
Priority Concepts: Client Education; Safety
Reference: Burchum, Rosenthal (2016), p. 263.

846. Answer: 4

Rationale: Risperidone can cause orthostatic hypotension. Sunlight should be
avoided by the client taking this medication. With any psychotropic medication,
caution needs to be taken (such as with driving or other activities requiring

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