Midterm: ATI Mental Health Unit 4 (Ch. 21-26) and Chapter 31 Practice Questions

A nurse is caring for a client who takes paroxetine to treat post traumatic stress disorder. The client states, "I grind my teeth during the night, which causes pain in my mouth." The nurse should identify which of the following interventions as possible measures to manage the client's bruxism? (Select all that apply.) a. Concurrent administration of buspirone b. Administration of a different SSRI c. Use of a mouth guard d. Changing to a different class of antianxiety medication e. Increasing the dose of paroxetine

A. CORRECT: Concurrent administration of a low‐dose of buspirone is an effective measure to managethe adverse effect of paroxetine. B. Other SSRIs will also have bruxism as an adverse effect therefore this is not an effective measure. C. CORRECT: Using a mouth guard during sleep can decrease the risk for oral damage resulting from bruxism. D. CORRECT: Changing to a different class of antianxiety medication that does not have the adverse effectof bruxism is an effective measure. E. Increasing the dose of paroxetine can cause the adverse effect of bruxism to worsen therefore this is not an effective measure.

A nurse is discussing routine follow‐up needs with a client who has a new prescription for valproate. The nurse should inform the client of the need for routine monitoring of which of the following? A. AST/ALT and LDH B. Creatinine and BUN C. WBC and granulocyte counts D. Blood sodium and potassium

A. CORRECT: Routine monitoring of liver function tests is necessary due to the risk for hepatotoxicity. B. Baseline levels can be drawn. However, routine monitoring of creatinine and BUN is not necessary. C. Baseline levels can be drawn. However, routine monitoring of WBC and granulocyte counts is not necessary. D. Baseline levels can be drawn. However, routine monitoring of blood sodium and potassium is not necessary.

A nurse is teaching the guardians of a child whohas autism spectrum disorder about indications of imipramine toxicity. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Seizures B. Agitation C. Photophobia D. Dry mouth E. Irregular pulse

A. CORRECT: Seizures are an indication of TCA toxicity. B. CORRECT: Agitation is an indication of TCA toxicity. C. photophobia is an anticholinergic effect rather than an indication of TCA toxicity. D. Dry mouth is an anticholinergic effect rather than an indication of TCA toxicity E. CORRECT: Irregular pulse can indicate a dysrhythmia which is an indication of TCA toxicity.

A nurse is caring for a client who is screaming at staff members and other clients. Which of the following is a therapeutic response by the nurse to the client? a. "Stop screaming, and walk with me outside." b. "Why are you so angry and screaming at everyone?" c. "You will not get your way by screaming." d. "What was going through your mind when you started screaming?

A. CORRECT: This is an appropriate therapeutic response. Setting limits and the use of physical activity (walking) to deescalate anger is an appropriate intervention. B. "Why" questions imply criticism and will often cause the client to become defensive. C. This is a closed‐ended, nontherapeutic statement. D. The client is not ready to discuss this issue.

A nurse is providing teaching to a client who has a new prescription for amitriptyline. Which of the following statements by the client indicates an understanding of the teaching? a. "I can expect to experience diarrhea while taking this medication." b. "I may feel drowsy for a few weeks after starting this medication." c. "I cannot eat my favorite pizza with pepperoni while taking this medication." d. "This medication will help me lose the weight that I have gained over the last year."

A. Constipation rather than diarrhea can occur with TCAs, due to anticholinergic effects. B. CORRECT: Sedation is an adverse effect of amitriptyline during the first few weeks of therapy. C. Foods (pepperoni) should be avoided if the client is prescribed an MAOI rather than a TCA like amitriptyline. D. Observe for manifestations of hypomania or mania caused by CNS stimulation with phenelzine.

A nurse is caring for a client who is speaking in a loud voice with clenched fists. Which of the following actions should the nurse take? A. Insist that the client stop yelling. B. Request that other staff members remain close by. C. Move as close to the client as possible. D. Walk away from the client.

A. Do not make demands of the client by insisting that they stop yelling. B. CORRECT: Request that other staff members remain close by to assist if necessary. C. Clients who are angry need a large personal space. D. Never walk away from a client who is angry. It is the nurse's responsibility to intervene as appropriate.

A nurse is assessing a client 4 hr after receiving an initial dose of fluoxetine Which of the following findings should the nurse report to the provider as indications of serotonin syndrome? (Select all that apply.) A. Hypothermia B. Hallucinations C. Muscular flaccidity D. Diaphoresis E. Agitation

A. Fever, rather than hypothermia, is an indication of serotonin syndrome. B. CORRECT: Hallucinations are an indication of serotonin syndrome. C. Muscle tremors, rather than flaccidity, are an indication of serotonin syndrome. D. CORRECT: Diaphoresis is an indication of serotonin syndrome. E. CORRECT: Agitation is an indication of serotonin syndrome.

A nurse is caring for a client who has schizophrenia and exhibits a lack of grooming and a flataffect. The nurse should expect a prescriptionfor which of the following medications? A. Chlorpromazine B. Thiothixene C. Risperidone D. Haloperidol

A. First‐generation antipsychotics (chlorpromazine) are used mainly to control positive, rather than negative, symptoms of schizophrenia. B. First‐generation antipsychotics (thiothixene) are used mainly to control positive symptoms of schizophrenia. C. CORRECT: Second‐generation antipsychotics (risperidone) are effective in treating negative symptoms of schizophrenia (lack of grooming and flat affect). D. First‐generation antipsychotics (haloperidol) are used mainly to control positive symptoms of schizophrenia.

A nurse is conducting group therapy with a group of clients. Which of the following statements made by a client is an example of aggressive communication? A. "I wish you would not make me angry." B. "I feel angry when you leave me." C. "It makes me angry when you interrupt me." D. "You'd better listen to me."

A. This statement does not imply a threat, nor does it indicate a lack of respect for another individual. B. This statement does not imply a threat, nor does it indicate a lack of respect for another individual. C. This statement does not imply a threat, nor does it indicate a lack of respect for another individual. D. CORRECT: This statement implies a threat and a lack of respect for another individual.

A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity. Which of the following actions is the nurse's priority? A. Administer flumazenil. B. Identify the client's level of orientation. C. Infuse IV fluids. D. prepare the client for gastric lavage.

A. Administer flumazenil will reverse the effects benzodiazepines; however, another action is the priority. B. CORRECT: When taking the nursing process approach to client care, the initial step is assessment. Identifying the client's level of orientation is the priority action. C. Infuse IV fluids to maintain blood pressure; however, another action is the priority. D. Gastric lavage will remove excessive medication from the client's GI system; however, another action is the priority.

A nurse is caring for a client who is taking phenelzine For which of the following manifestations should the nurse monitor as an adverse effectof this medication? (Select all that apply.) A. Elevated blood glucose level B. Orthostatic hypotension C. Priapism D. Hypomania E. Bruxism

A. An elevated blood glucose level is not an adverse effect of phenelzine. B. CORRECT: Observe for orthostatic hypotension, which is an adverse effect of phenelzine. C. priapism is an adverse effect of trazodone rather than phenelzine. D. CORRECT: Observe for a headache which is an adverse effect of phenelzine. E. Bruxism is an adverse effect of SSRIs rather than phenelzine.

A nurse is discussing early indications of toxicity with a client who has a new prescription for lithium carbonate for bipolar disorder. The nurse should include which of the following manifestations in the teaching? (Select all that apply.) A. Constipation B. polyuria C. Rash D. Muscle weakness E. Tinnitus

A. Diarrhea, rather than constipation, is an early indication of lithium toxicity. B. CORRECT: polyuria is an early indication of lithium toxicity. C. A rash is not indication of lithium toxicity. D. CORRECT: Muscle weakness is an early indication of lithium toxicity.E. Tinnitus is an indication of severe, rather than early, toxicity.

A nurse is caring for a client who is to begin taking fluoxetine for treatment of panic disorder. Which of the following statements indicates the client understands the use of this medication? a. "I will take the medication at bedtime." b. "I will follow a low‐sodium diet while taking this medication." c. "I will need to discontinue this medication slowly." d. "I will be at risk for weight loss with long‐term use of this medication."

A. The client should take fluoxetine in the morning to minimize sleep disturbances. B. The client is at risk for hyponatremia while taking fluoxetine. C. CORRECT: When discontinuing fluoxetine, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome. D. The client is at risk for weight gain, rather than loss, with long‐term use of fluoxetine.

A nurse is caring for a school age child who has conduct disorder and a new prescription for methylphenidate transdermal patches. Which of the following information should the nurse provide about the medication? a. Apply the patch once daily at bedtime. b. Place the patch carefully in a trash can after removal. c. Apply the transdermal patch to the anterior waist area. d. Remove the patch each day after 9 hr.

A. The transdermal patch is applied once daily in the morning. B. For safety when discarding the transdermal preparation, the client should fold the patch and flush it downthe toilet to prevent others from using it. C. The transdermal patch should be applied to a clean, dry area on the hip, and the waist area should be avoided. D. CORRECT: The transdermal patch is applied once daily in the morning and is removed after 9 hr.

A nurse is teaching a client who has a new prescription for alprazolam for generalized anxiety disorder. Which of the following information should the nurse provide? a. Three to six weeks of treatment is required to achieve therapeutic benefit. b. Combining alcohol with alprazolam will produce a paradoxical response. c. Alprazolam has a lower risk for dependence than other antianxiety medications. d. Report confusion as a potential indication of toxicity.

A. Buspirone, rather than alprazolam, requires 3 to 6 weeks to achieve therapeutic benefit. B. Combining alcohol with alprazolam can produce CNS and respiratory depression rather than a paradoxical response. C. Alprazolam is preferably used for short‐term treatment because of the increased risk of dependence. D. CORRECT: Confusion is a potential indication of alprazolam toxicity that the client should report to the provider.

A nurse is teaching a child who has intermittent explosive disorder about a new prescription for fluoxetine. Which of the following information should the nurse provide? (Select all that apply.) a. An adverse effect of this medication is CNS depression. b. Administer the medication in the morning. c. Monitor for weight loss while taking this medication. d. Therapeutic effects of this medication will take 1 to 3 weeks to fully develop. e. This medication blocks the synaptic reuptake of serotonin in the brain.

A. An adverse effect of fluoxetine is CNS stimulation rather than CNS depression. B. CORRECT: Fluoxetine should be administered in the morning due to the potential for insomnia. C. CORRECT: Fluoxetine can result in weight loss. D. Initial therapeutic effects of fluoxetine occur in 1 to 3 weeks, with full effectiveness occurring by 12 weeks. E. CORRECT: Fluoxetine works by blocking the synaptic reuptake of serotonin, allowing more serotonin to stay at the junction of the neurons.

A nurse is providing discharge teaching for a client who has schizophrenia and a new prescription for iloperidone. Which of the following client statements indicates understanding of the teaching? a. "I will be able to stop taking this medication as soon as I feel better." b. "If I feel drowsy during the day, I will stop taking this medication and call my provider." c. "I will be careful not to gain too much weight while taking this medication." d. "This medication is highly addictive and must be withdrawn slowly."

A. Antipsychotic medications are considered a long‐term treatment for schizophrenia. Discontinuing the medication can result in an exacerbation of manifestations. B. Drowsiness is a common adverse effect of antipsychotic medications. However, it is not appropriate to discontinue the medication. C. CORRECT: Antipsychotic medications (iloperidone) have a high risk for significant weight gain. D. Antipsychotic medications are not considered addictive, and it is not necessary to titrate iloperidone when discontinuing treatment.

A nurse is providing teaching to a client who has alcohol use disorder and a new prescription for carbamazepine. Which of the following information should the nurse include in the teaching? a. "This medication will help prevent seizures during alcohol withdrawal." b. "Taking this medication will decrease your cravings for alcohol." c. "This medication maintains your blood pressure at a normal level during alcohol withdrawal." d. "Taking this medication will improve your ability to maintain abstinence from alcohol."

A. CORRECT: Carbamazepine is used during withdrawal to decrease the risk for seizures. B. Carbamazepine is used to promote safe withdrawal rather than to decrease cravings for alcohol. C. Clonidine or propranolol is used during withdrawal to depress the autonomic response and its effect on blood pressure. D. Carbamazepine is used to promote safe withdrawal rather than abstinence.

A nurse is caring for a client who is experiencing extreme mania due to bipolar disorder. prior to administration of lithium carbonate, the client's lithium blood level is 1.2 mEq/L. Which of the following actions should the nurse take? a. Administer the next dose of lithium carbonate as scheduled. c. Prepare for administration of aminophylline. c. Notify the provider for a possible increase in the dosage of lithium carbonate. d. Request a stat repeat of the client's lithium blood level.

A. CORRECT: During a manic episode, the lithium blood level should be 0.8 to 1.4 mEq/L. It is appropriate to administer the next dose as scheduled. B. Aminophylline can be prescribed for treatment of severe toxicity for levels greater than 1.5 mEq/L. C. A dosage increase would place the client at risk for toxicity and is therefore not an appropriate action. D. A lithium level of 1.2 mEq/L is an expected finding fora client who is experiencing a manic episode. It is not necessary to request a stat repeat of the laboratory test.

A nurse is providing teaching to an adolescent client who has a new prescription for clomipramine for OCD. Which of the following information should the nurse provide? a. Eat a diet high in fiber. b. Check temperature daily. c. Take medication first thing in the morning before eating. d. Add extra calories to the diet as between‐meal snacks.

A. CORRECT: Eating a diet high in fiber will decrease constipation, an anticholinergic effect associated with TCA use. B. Checking the client's temperature daily is not necessary while taking a TCA. C. Taking the medication at bedtime rather than in the morning will prevent daytime sleepiness. D. Following a well‐balanced diet plan rather than adding extra calories as snacks will help prevent weight gain, a common adverse effect of TCAs.

A nurse is discussing the use of methadone witha newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? (Select all that apply.) a. "Methadone is a replacement for physical dependence to opioids." b. "Methadone reduces the unpleasant effects associated with abstinence syndrome." c. "Methadone can be used during opioid withdrawal and to maintain abstinence." d. "Methadone increases the risk for acetaldehyde syndrome." e. "Methadone must be prescribed and dispensed by an approved treatment center."

A. CORRECT: Methadone is an oral opioid agonist that replaces the opioid to which the client has a physical dependence. B. CORRECT: Methadone administration prevents abstinence syndrome from occurring. C. CORRECT: Methadone substitution is used for both opioid withdrawal and long‐term maintenance. D. Disulfiram, rather than methadone, places the client at risk for acetaldehyde syndrome if the client consumes alcohol while taking the medication. E. CORRECT: Due to the risk for physical dependence, methadone is required to be prescribed and dispensed by an approved treatment center.

A charge nurse is discussing mirtazapine with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding? a. "This medication increases the release of serotonin and norepinephrine." b. "I should tell the client about the likelihood of insomnia while taking this medication." c. "This medication is contraindicated for clients who have an eating disorder." d. "Sexual dysfunction is a common adverse effect of this medication."

A. CORRECT: Mirtazapine provides relief from depression by increasing the release of serotonin and norepinephrine. B. Tell the client about the likelihood of drowsiness rather than insomnia when taking this medication. C. Bupropion, rather than mirtazapine, is contraindicated in clients who have an eating disorder. D. Sexual dysfunction is an adverse effect of SSRIs rather than mirtazapine.

A nurse is caring for a client who takes ziprasidone. The client reports difficulty swallowing the oral medication and becomes extremely agitated with injectable administration. The nurse should contact the provider to discuss a change to which of the following medications? (Select all that apply.) A. Olanzapine B. Quetiapine C. Aripiprazole D. Clozapine E. Asenapine

A. CORRECT: Olanzapine is available in an orally disintegrating tablet, which is appropriate for clients who have difficulty swallowing oral tablets. This route also decreases therisk for agitation associated with an injection. B. Quetiapine is available only in tablets or extended‐release tablets and will therefore not address the current concerns with medication administration. C. CORRECT: Aripiprazole is available in an orally disintegrating tablet, which is appropriate for clients who have difficulty swallowing oral tablets. This route also decreases therisk for agitation associated with an injection. D. CORRECT: Clozapine is available in an orally disintegrating tablet, which is appropriate for clients who have difficulty swallowing oral tablets. This route also decreases therisk for agitation associated with an injection. E. CORRECT: Asenapine is available in a sublingual tablet, which is appropriate for clients who have difficulty swallowing oral tablets. This route also decreases the risk for agitation associated with an injection.

A nurse is teaching a client who has a new prescription for imipramine how to minimize anticholinergic effects. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) a. Void just before taking the medication. b. Increase the dietary intake of potassium. c. Wear sunglasses when outside. d. Change positions slowly when getting up. e. Chew sugarless gum.

A. CORRECT: Voiding just before taking the medication will help minimize the anticholinergic effectsof urinary hesitancy or retention. B. The anticholinergic effects of imipramine do not affect the client's potassium level. C. CORRECT: Wearing sunglasses when outside will help minimize the anticholinergic effect of photophobia. D. The client should change positions slowly to avoid orthostatic hypotension. However, this is not an anticholinergic effect. E. CORRECT: Chewing sugarless gum will help minimize the anticholinergic effect of dry mouth.

A charge nurse is discussing manifestations of schizophrenia with a newly licensed nurse. Whichof the following manifestations should the charge nurse identify as being effectively treated by first‐generation antipsychotics? (Select all that apply.) A. Auditory hallucinations B. Withdrawal from social situations C. Delusions of grandeur D. Severe agitation E. Anhedonia

A. CORRECT: positive symptoms of schizophrenia (auditory hallucinations) are effectively treated with first‐generation antipsychotics. B. First‐generation antipsychotics have minimal effectiveness with negative symptoms of schizophrenia (social withdrawal). C. CORRECT: positive symptoms of schizophrenia (delusions of grandeur) are effectively treated with first‐generation antipsychotics. D. CORRECT: positive symptoms of schizophrenia (severe agitation) are effectively treated with first‐generation antipsychotics. E. First‐generation antipsychotics have minimal effectiveness with negative symptoms of schizophrenia (anhedonia).

A nurse is evaluating a client's understanding of a new prescription for clonidine for the treatment of opioid use disorder. Which of the following statements by the client indicates an understanding of the teaching? a. "Taking this medication will help reduce my craving for heroin." b. "While taking this medication, I should keep a pack of sugarless gum." c. "I can expect some diarrhea from taking this medicine." d. "Each dose of this medication should be placed under my tongue to dissolve."

A. Clonidine is useful during opioid withdrawal. However, it does not reduce cravings. B. CORRECT: Clonidine commonly causes clients to experience dry mouth. Chewing sugarless gum is an effective method to address this adverse effect. C. Clonidine reduces, rather than causes, diarrhea and other withdrawal manifestations related to autonomic hyperactivity. D. Buprenorphine, rather than clonidine, is administered sublingually.

A nurse is assessing a client who is currently taking perphenazine. Which of the following findings should the nurse identify as an extrapyramidal symptom (EpS)? (Select all that apply.) A. Decreased level of consciousness B. Drooling C. Involuntary arm movements D. Urinary retention E. Continual pacing

A. Decreased level of consciousness is an indication of neuroleptic malignant syndrome rather than an EPS. B. CORRECT: Drooling is an indication of pseudoparkinsonism, which is an EPS. C. CORRECT: Involuntary arm movements are an indication of tardive dyskinesia, which is an EPS. D. Urinary retention is an anticholinergic effect rather than an EPS. E. CORRECT: Continual pacing is an indication of akathisia, which is an EPS.

A nurse is caring for a client in an inpatient mental health facility who gets up from a chair and throws it across the day room. Which of the following is the priority nursing action? A. Encourage the client to express feelings out loud. B. Maintain eye contact with the client. C. Move the client away from others. D. Tell the client that the behavior is not acceptable.

A. Encouraging the client to express feelings out loud is appropriate. However, it is not the priority action. B. Maintaining eye contact with the client is appropriate. However, it is not the priority action. C. CORRECT: The behavior indicates that the client is at greatest risk for harming others. The priority action for the nurse is to move the client away from others. D. It is appropriate to tell the client that the behavior is not acceptable. However, it is not the priority action.

A nurse is caring for a client who is prescribed lithium therapy. The client tells of the plan to take ibuprofen for osteoarthritis pain relief. Which of the following statements should the nurse make? a. "That is a good choice. Ibuprofen does not interact with lithium." b. "Regular aspirin would be a better choice than ibuprofen." c. "Lithium decreases the effectiveness of ibuprofen." d. "The ibuprofen will make your lithium level fall too low."

A. Ibuprofen is not recommended for clients taking lithium. B. CORRECT: Aspirin is recommended as a mild analgesic rather than ibuprofen due to the risk for lithium toxicity. C. Lithium does not decrease the effectiveness of ibuprofen. However, concurrent use is not recommended due to the risk of toxicity. D. Ibuprofen increases the risk for a toxic, rather than low, lithium level.

A nurse is providing teaching to an adolescent client who is to begin taking atomoxetine for ADHD. The nurse should instruct the client to monitor for which of the following adverse effects? (Select all that apply.) A. Somnolence B. Yellowing skin C. Increased appetite D. Fever E. Malaise

A. Insomnia, rather than somnolence, is an adverse effect that the client should report to the provider. B. CORRECT: Yellowing skin is a potential indication of hepatotoxicity that the client should report to the provider. C. Decreased appetite with resulting weight loss, rather than increased appetite, is a potential adverse effect that the client should report to the provider. D. CORRECT: Fever is a potential indication of hepatotoxicity that the client should report to the provider. E. CORRECT: Malaise is a potential indication of hepatotoxicity that the client should report to the provider.

A nurse is admitting a client who has a new diagnosis of bipolar disorder and is scheduled to beginlithium therapy. When collecting a medical history from the client's caregiver, which of the following statements is the priority to report to the provider? a. "Current medical conditions include diabetes that is controlled by diet." b. "Recent medications include a course of prednisone for acute bronchitis." c. "Current vaccinations include a flu vaccine last month." d. "Current medications include furosemide for congestive heart failure."

A. It is important to notify the provider of the client's medical history. However, this information does not pose the greatest risk to the client and is therefore not the priority. B. It is important to notify the provider of the client's medical history. However, this information does not pose the greatest risk to the client and is therefore not the priority. C. It is important to notify the provider of the client's medical history. However, this information does not pose the greatest risk to the client and is therefore not the priority. D. CORRECT: Diuretics (furosemide) are contraindicated for use with lithium due to the risk for toxicity. Thisis the greatest risk for the client and is therefore the highest priority to report to the provider.

A nurse is assessing a client in an inpatient mental health unit. Which of the following findings should the nurse expect if the client is in the preassaultive stage of violence? (Select all that apply.) A. Lethargy B. Defensive responses to questions C. Disorientation D. Facial grimacing E. Agitation

A. Lethargy is more likely to be observed in a client who has depression. B. CORRECT: Defensive responses to questions are an assessment finding that can indicate that a client is in the preassaultive stage of violence. C. Disorientation is more likely to be assessed in a client who has a cognitive disorder. D. CORRECT: Facial grimacing is an assessment finding that can indicate that a client is in the preassaultive stage of violence. E. CORRECT: Agitation is an assessment finding that can indicate that a client is in the preassaultive stage of violence.

A nurse is assisting in the discharge planningfor a client following alcohol detoxification. The nurse should expect prescriptions for which of the following medications to promote long‐term abstinence from alcohol? (Select all that apply.) A. Lorazepam B. Diazepam C. Disulfiram D. Naltrexone E. Acamprosate

A. Lorazepam is prescribed for short‐term use during withdrawal. B. Diazepam is prescribed for short‐term use during withdrawal. C. CORRECT: Disulfiram promotes abstinence through aversion therapy. D. CORRECT: Naltrexone promotes abstinence by suppressing the craving and pleasurable effects of alcohol. E. CORRECT: Acamprosate decreases the unpleasant effects resulting from abstinence.

A nurse is reviewing the medical record of a client who has a new prescription for bupropion for depression. Which of the following findings is the priority for the nurse to report to the provider? a. The client has a family history of seasonal pattern depression. b. The client currently smokes 1.5 packs of cigarettes per day. c. The client had a motor vehicle crash last year and sustained a head injury. d. The client has a BMI of 25 and has gained 10 lb over the last year.

A. Report family history information. However, this does not address the greatest risk to the client and is not the priority. B. Report the client's current smoking status. However, this does not address the greatest risk to the client and is not the priority. C. CORRECT: The greatest risk to the client is development of seizures. Bupropion can lower the seizure threshold and should be avoided by clients who have a history of a head injury. This information is the highest priority to report to the provider. D. Report the client's BMI and change in weight. However, this does not address the greatest risk to the client and is not the priority.

A nurse is teaching a client who has tobacco use disorder about the use of nicotine gum. Which of the following information should the nurse include in the teaching? a. Chew the gum for no more than 10 min. b. Rinse out the mouth immediately before chewing the gum. c. Avoid eating 15 min prior to chewing the gum. d. Use of the gum is limited to 90 days.

A. The client should chew the gum slowly and intermittently over 30 min. B. The client should avoid drinking 15 min prior to chewing the gum. C. CORRECT: The client should avoid eating or drinking 15 min prior to and while chewing the gum. D. Use of nicotine gum is not recommended for longer than 6 months.