A client diagnosed with complex somatic symptom disorder and depression is prescribed medication therapy to treat both the pain and the symptoms of depression. When teaching the client about the medication, which of the following would the nurse emphasize?
- A. Need for signing a no-suicide contract
- B. Avoidance of foods that contain aged cheese
- C. Use of sunscreen when exposed to bright sunlight
- D. Limiting of the amount of water ingested
Correct Answer: B
Rationale: The correct answer is B: Avoidance of foods that contain aged cheese. Aged cheese contains tyramine, which can interact with certain medications used to treat depression, such as MAOIs. This interaction can lead to a dangerous increase in blood pressure known as a hypertensive crisis. Therefore, it is crucial for the client to avoid foods high in tyramine, such as aged cheese, to prevent this potentially life-threatening reaction. Signing a no-suicide contract (choice A) is important but not directly related to medication teaching. Using sunscreen (choice C) and limiting water intake (choice D) are not relevant considerations for this medication regimen.
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A nurse is reviewing common themes or social determinants among populations preventing clients' achievement of health care"“related goals. The nurse wants to include interventions into the clients' plan of care to help overcome effects of the identified social determinants. What would the nurse use to base conclusions?
- A. Healthy People 2030
- B. community-based outcomes
- C. culturally competent therapy
- D. national client safety goals
Correct Answer: A
Rationale: The correct answer is A: Healthy People 2030. This is a comprehensive set of national health objectives designed to identify and address the most significant health issues facing the population. The nurse would use Healthy People 2030 to base conclusions because it provides evidence-based goals and strategies to improve health outcomes and address social determinants of health.
Explanation:
1. Healthy People 2030 is a national initiative that focuses on improving the health and well-being of individuals and communities.
2. It includes specific objectives related to social determinants of health, such as poverty, education, and access to healthcare.
3. By using Healthy People 2030, the nurse can identify relevant interventions and strategies to address the identified social determinants and improve clients' health outcomes.
Summary:
B: Community-based outcomes may be relevant for specific interventions but do not provide the comprehensive national perspective needed to address social determinants.
C: Culturally competent therapy is important but focuses on individualized care rather than addressing broader social determin
A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, the nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer?
- A. Diphenhydramine (Benadryl)
- B. Propranolol (Inderal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: A
Rationale: The correct answer is A: Diphenhydramine (Benadryl). Dystonic reactions are extrapyramidal side effects commonly seen with antipsychotic medications. Diphenhydramine is a first-line treatment for dystonic reactions due to its anticholinergic properties. It helps block the excessive dopamine activity in the brain that causes these reactions. Propranolol (B) is a beta-blocker and not typically used for dystonic reactions. Risperidone (C) and Aripiprazole (D) are antipsychotic medications themselves and would not be used to treat dystonic reactions caused by antipsychotic medications.
While caring for a family, the nurse determines that first-order changes have occurred with which of the following?
- A. The children are all in school, and the parent returns to work.
- B. The daughter leaves home to attend college.
- C. The son marries his long-time sweetheart and moves into his own home.
- D. The grandmother who has been living in the household dies.
Correct Answer: A
Rationale: The correct answer is A because first-order changes refer to small, incremental adjustments within the system. In this scenario, the parent returning to work while the children are all in school signifies a gradual shift in the family dynamic. The other choices involve significant and more disruptive changes like a daughter leaving for college, a son getting married and moving out, and the death of a family member, which are considered second-order changes that lead to more substantial shifts in the family system.
A client with signs and symptoms of double pneumonia states,"I will not agree to hospital admission unless my shaman is allowed to continue helping me." Which would be an appropriate nursing intervention?
- A. Tell the client that the shaman is not allowed in the emergency department.
- B. Have the shaman meet the attending physician at the hospital.
- C. Have the family talk the client into admission without the shaman.
- D. Explain to the client that the shaman is responsible for the client's condition.
Correct Answer: B
Rationale: The correct answer is B. Having the shaman meet the attending physician at the hospital is the most appropriate nursing intervention because it allows for collaboration between traditional beliefs and modern medical care. This approach respects the client's cultural and spiritual preferences while ensuring the client receives necessary medical treatment. It also helps establish a supportive and holistic care environment.
Choice A is incorrect because denying the shaman access may lead to resistance from the client and hinder effective communication and trust-building. Choice C is inappropriate as it disregards the client's autonomy and may create conflict within the family. Choice D is incorrect as blaming the shaman for the client's condition is disrespectful and unprofessional.
Malika agrees to try losing weight according to the nurse practitioner's outlined plan. Additional teaching is warranted when Malika states:
- A. I am willing to admit I am depressed.
- B. Psychotherapy will be a part of my treatment.
- C. I prefer to have a gastric bypass rather than use this plan.
- D. My comorbid conditions may improve with weight loss.
Correct Answer: C
Rationale: Rationale:
C is correct because choosing gastric bypass over the outlined plan indicates a lack of commitment to the agreed weight loss plan. It suggests that Malika may not be fully engaged in following the recommendations provided by the nurse practitioner. This choice also implies a preference for a more invasive and potentially risky procedure over a more conservative approach. Options A, B, and D are incorrect because they do not challenge or contradict the nurse practitioner's plan, indicating a willingness to address depression, engage in psychotherapy, and recognize potential benefits of weight loss on comorbid conditions.
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