Nokea
A client has been taking imipramine [Tofranil] for his depression for 2 days. His sister asks the nurse, 'Why is he still so depressed?' Which of the following responses by the nurse is most appropriate?
- A. Your brother is experiencing a very serious depression.
- B. I'll be sure to convey your concern to his physician.
- C. It takes 2 to 4 weeks for the drug to reach its full effect.
- D. Perhaps we need to change his medication.
Correct Answer: C
Rationale: Imipramine, a tricyclic antidepressant, typically requires 2 to 4 weeks to achieve therapeutic effects as it needs time to alter neurotransmitter levels. This response educates the sister accurately about the medication's timeline.
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During you musculoskeletal assessment of the client, you determine that the client has muscular strength against gravity but not against resistance. You would document this assessment as:
- A. 1 on the scale of 1 to 3
- B. 2 on the scale of 1 to 5
- C. 3 on the scale of 0 to 5
- D. 4 on the scale of 0 to 5
Correct Answer: C
Rationale: Muscular strength against gravity but not resistance is graded as 3 on the 0-5 scale, indicating fair strength.
The nurse is caring for a client with a history of venous insufficiency. Which of the following interventions is most appropriate?
- A. Encourage prolonged standing.
- B. Apply compression stockings.
- C. Keep the legs in a dependent position.
- D. Limit fluid intake.
Correct Answer: B
Rationale: Compression stockings improve venous return and reduce swelling in venous insufficiency.
A client demonstrating unstable ventricular tachycardia (VT) loses consciousness and becomes pulseless after an initial treatment with a dose of lidocaine intravenously. Which item should the nurse caring for the client immediately obtain?
- A. A pacemaker
- B. A defibrillator
- C. A second dose of lidocaine
- D. An electrocardiogram machine
Correct Answer: B
Rationale: For the client with VT who becomes pulseless, the primary health care provider or qualified advanced cardiac life support personnel immediately defibrillate the client. In the absence of this equipment, cardiopulmonary resuscitation is initiated immediately. None of the remaining options are items that are needed immediately to manage this situation.
A primary concern of the hospitalized adolescent is:
- A. Respect for the need for privacy.
- B. Allowing parents to visit after hours.
- C. Wearing a hospital gown.
- D. The fear of loss of control when in pain.
Correct Answer: A
Rationale: Adolescents value autonomy and privacy, which is a primary concern during hospitalization, as it supports their developmental need for independence.
A client is being treated for acute low back pain. Which of these clinical manifestations must be reported to the physician immediately?
- A. Diffuse, aching sensation in the L4 to L5 area
- B. New onset of footdrop
- C. Pain in the lower back when the leg is lifted
- D. Pain in the lower back that radiates to the hip
Correct Answer: B
Rationale: New onset footdrop indicates possible nerve compression or damage, requiring immediate reporting to prevent permanent impairment. Other symptoms are common in low back pain and less urgent.