invalid Hesi question or just tricky

[the-needle-pusher]

I need some one to explain to me according to one of these hesi questions how is that possible when you're educating a Pt about Buspar (buspirone); the right answer according to "HESI" is telling him it takes 2 -3 weeks to start kick in, while the other option which is to tell the Pt not to drink alcohol with that medication is the wrong option?? based on that I conclude that letting the patient know when the meds start working is more important than telling him to avoid alcohol even though it could have lethal Side effects !! I mean really ?!!!

[KarenMS]

I originally wrote here that I don't think buspirone and alcohol typically have lethal side effects, but am changing it because it is possible even if not probable.

[KarenMS]

I guess it's always a concern. But without reading the question, it's hard to tell what stem words may have been leading to wanting an answer about compliance rather than safety.

[WookieeRN, BSN, MSN, RN]

I would say the priority is informing them that it takes 2-3 weeks to work is because they will most likely go off it because it's "not working" in 3 days if they haven't been told a realistic time frame.

[the-needle-pusher]

I see your point of view, but chances having side effects is bigger than chances of the pt quitting taking the meds!! most of psych pts know about drugs and meds more than nurses themselves, and I wouldn't Assume they know but also I will not assume they will quit !!

[the-needle-pusher]

well my argument is not about whether or not its lethal, rather how the question present the meds S/E are less important than telling the pt about the meds time frame!!

[KarenMS]

well my argument is not about whether or not its lethal, rather how the question present the meds S/E are less important than telling the pt about the meds time frame!!

Right, so it really just depends on the wording of the question and what they were really asking. Could there have been a stem word in the question that related to compliance or something like that? If so, then educating about side effects isn't the answer to this exact question, even if it's ultimately more important. But like I said, it's hard to know without seeing the whole question.

[Scottishtape]

I think it's a legit question.

Keep in mind that these tests are not meant to figure it what you would do in specific situations per say. They are designed to see if you actually know the med/disease/etc.

Do we all know meds shouldn't be mixed with alcohol? Of course. My 14 year old knows that. Does she know that this med will take 3 weeks or so to kick in? No. It's trying to see if you have actually gained the knowledge you need, not just being able to pick the most obvious answer.

[WookieeRN, BSN, MSN, RN]

I see your point of view, but chances having side effects is bigger than chances of the pt quitting taking the meds!! most of psych pts know about drugs and meds more than nurses themselves, and I wouldn't Assume they know but also I will not assume they will quit !!

Was this a priority teaching question? Its hard to tell what the question was really asking without seeing it, but I have a feeling it was more of a compliance question than a safety question. Many psych meds take forever and a day to get to a therapeutic level and that's the biggest risk for noncompliance. Noncompliance is a big issue with psych meds, period. If this was lithium, I would probably educate them about the side effects because that's a large part of why many people on it stop taking it, however, Buspar is used for anxiety and it would be extremely important to inform this patient that it will take 2-3 weeks to work, because otherwise they will assume it with start working immediately and then stop taking it when it doesn't work and their anxiety doesn't improve (this happens way more often than you think). I also think that alcohol only worsens nervous system symptoms like dizziness so if the stem was about safety I could see why not drinking alcohol would be priority. I think the best way to approach these questions is to determine the stem of the question, then tell yourself you can do one of these options and walk out of the room. What is the worst thing that can happen if you don't do each of the options present?

[Purple_roses]

I think it's because the question wants to see if you know the specifics of that med. If a patient doesn't know that it takes a few weeks to kick in, they may get discouraged and stop taking it.

[Purple_roses]

well my argument is not about whether or not its lethal, rather how the question present the meds S/E are less important than telling the pt about the meds time frame!!

Telling patients not to take certain meds with alcohol is true for so many meds out there. It's kind of like when a pharmacology question asks you about med side effects--if nausea and vomiting is on there, you *almost* never pick it, because nausea and vomiting can occur with most meds out there. I think NCLEX style questions often put obvious answers on there to test critical thinking skills. You would tell patients not to drink alcohol with many many meds; but do you know the specifics of the med in question? That's what the question is trying to see.

If a person with anxiety and panic attacks stops taking anti-anxiety meds, that can jeopardize their safety. So education with the goal of compliance is a big priority here.

[Anonymous865]

If you look at the prescribing information put out by the manufacturer, you will find

"While formal studies of the interaction of BuSpar with alcohol indicate that buspirone does not increase alcohol-induced impairment in motor and mental performance, it is prudent to avoid concomitant use of alcohol and buspirone."

My guess is that the question is trying to get you to differentiate between

- the warnings that comes with just about any medication that it's a good idea to avoid alcohol and it's a good idea not to drive or operate machinery until you know how it affects you.

vs.

- We know this medication takes several weeks to reach an effective level.