Nokea
A client tells the RN she has decided to stop taking sertraline (Zoloft) because she doesn't like the nightmares, sex dreams, and obsessions she's experiencing since starting on the medication. What is an appropriate response by the nurse?
- A. It is unsafe to abruptly stop taking any prescribed medication.'
- B. Side effects and benefits should be discussed with your health care provider.'
- C. This medication should be continued despite unpleasant symptoms.'
- D. Many medications have potential side effects.'
Correct Answer: A
Rationale: Abrupt withdrawal may occasionally cause serotonin syndrome, consisting of lethargy, nausea, headache, fever, sweating, and chills. A slow withdrawal may be prescribed with sertraline to avoid dizziness, nausea, vomiting, and diarrhea.
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The nurse is talking with the parents of an adolescent client who was brought to the emergency department after making superficial cuts on the arms with a razor blade. There are several cuts in various stages of healing on the client’s forearms. Which of the following statements would be appropriate for the nurse to make? Select all that apply.
- A. This must be difficult for you
- B. Everything is going to be alright
- C. We have cleaned and bandaged the cuts
- D. Why did you wait until now to bring your child here?
- E. Tell me about when you started noticing this behavior
Correct Answer: A,C,E
Rationale: Acknowledging difficulty, confirming care, and exploring behavior onset are supportive and therapeutic. Assuring everything will be alright is dismissive, and questioning delay is judgmental.
While caring for a child with Reye's syndrome, the nurse should give which action the highest priority?
- A. Monitor intake and output
- B. Provide good skin care
- C. Assess level of consciousness
- D. Assist with range of motion
Correct Answer: C
Rationale: Assess level of consciousness. An altered level of consciousness suggests increasing intracranial pressure related to cerebral edema.
The nurse on a pediatric unit is caring for a 2-year-old client. Which of the following interventions are appropriate to reduce the distress of hospitalization on the child? Select all that apply.
- A. Encourage the parent to leave the child alone for short intervals
- B. Follow the child’s home sleep schedule and routine
- C. Integrate preferred snack foods into the child’s routine
- D. Point out body changes that may occur
- E. Provide various options when choosing toys
Correct Answer: B,C,E
Rationale: Maintaining sleep routines, offering preferred snacks, and providing toy choices reduce distress by promoting familiarity and autonomy. Leaving alone or discussing body changes may increase anxiety.
The nurse is talking with a client who is entering the second trimester of pregnancy. Which of the following information should the nurse include? Select all that apply.
- A. Anticipate experiencing light fetal movements around 16 to 20 weeks gestation
- B. Increase your consumption of iron-rich foods like meat and dried fruit
- C. Try to gain about 3 lb (1.4 kg) each week if your prepregnancy BMI was normal
- D. Expect to have an abdominal ultrasound scheduled to check fetal anatomy
- E. Plan to be screened for gestational diabetes mellitus around 24 to 28 weeks gestation
Correct Answer: A,B,D,E
Rationale: Fetal movement, iron intake, anatomy ultrasound, and diabetes screening are standard second-trimester recommendations. Weight gain should be about 1 lb/week for normal BMI, not 3 lb.
The nurse is caring for a client with a head injury who has increased ICP. The physician plans to reduce the cerebral edema by reversing dilation of cerebral blood vessels. Which physician prescription would the nurse expect to accomplish this?
- A. Hyperventilation per mechanical ventilation
- B. Insertion of a ventricular shunt
- C. Furosemide (Lasix)
- D. Methylprednisolone (Solu-Medrol)
Correct Answer: A
Rationale: Hyperventilation is utilized to decrease the PCO2 to 27-30, producing cerebral blood vessel constriction. Answers B, C, and D can decrease cerebral edema, but not by constriction of cerebral blood vessels; therefore, they are wrong.