The nurse completes medication education for the client receiving antihistamines. The nurse evaluates that learning has occurred when the client makes which statement?

Correct Answer: D

Rationale: Antihistamines, particularly first-generation ones (e.g., diphenhydramine), block H1 receptors but cross the blood-brain barrier, causing sedation. The statement 'This medication could make me very sleepy' shows the client understands this key side effect, indicating effective education. Alcohol exacerbates sedation, so that's incorrect. Increased fluids aren't specifically required unless addressing dry mouth, a secondary issue. OTC status doesn't guarantee safety, a common misconception. The nurse evaluates learning by the client's recognition of drowsiness, critical for safety (e.g., avoiding driving), making choice D the best evidence of comprehension.

Correct Answer: A

Rationale: Hydrogen peroxide is commonly used to soften and remove cerumen (earwax) impaction due to its effervescent properties, which help break down the wax. Rubbing alcohol (B) is used for drying the ear canal but is not effective for cerumen impaction. Charcoal (C) and clove oil (D) are not used for this purpose.

Correct Answer: A

Rationale: The nurse should include the instruction to avoid drinking large amounts of green tea when providing dietary teaching for a patient receiving warfarin therapy. Green tea is high in vitamin K, which can interfere with the effectiveness of warfarin, an anticoagulant medication. Maintaining a consistent intake of vitamin K is important for patients on warfarin in order to keep their INR (International Normalized Ratio) levels stable. It is not necessary to avoid all sources of vitamin K, but rather to keep intake consistent and moderate. Drinking large amounts of green tea, which is high in vitamin K, can potentially impact the patient's INR levels and increase the risk of bleeding or clotting issues.

Correct Answer: C

Rationale: Levothyroxine (Synthroid) is a synthetic thyroid hormone used to treat hypothyroidism. Overdose or excessive dosing can lead to symptoms of hyperthyroidism, including tachycardia (rapid heart rate), palpitations, and anxiety. Hypotension and bradycardia are not typical adverse effects of levothyroxine. Constipation is more commonly associated with hypothyroidism, not its treatment. Therefore, tachycardia is the correct answer as it reflects the potential for overstimulation of the cardiovascular system due to excessive thyroid hormone levels.

Correct Answer: D

Rationale: Paliperidone, a second-generation antipsychotic, treats schizoaffective disorder's psychotic and mood symptoms via D2 and 5HT2 antagonism. Its moderate sedative effect, less than chlorpromazine's, can aid sleep onset without excessive drowsiness, fitting her insomnia complaint. Lithium stabilizes mood but doesn't sedate or address psychosis directly. Chlorpromazine, a sedating first-generation antipsychotic, risks oversedation and EPS. Haloperidol, non-sedating, controls psychosis but not mood or sleep. Ziprasidone lacks strong sedation. Paliperidone's balanced profile manages her condition holistically, improving sleep while targeting core symptoms, per evidence.