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A client is being treated with an antidepressant for major depressive disorder. Which statement by the client indicates a need for further teaching?
- A. I know it may take several weeks before I start feeling better.
- B. I should avoid drinking alcohol while taking this medication.
- C. I will stop taking the medication as soon as I feel better.
- D. I should take the medication at the same time every day.
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. Stopping medication abruptly can lead to withdrawal symptoms and a potential relapse of depressive symptoms.
2. The client should be educated on the importance of completing the full course of treatment.
3. This statement indicates a lack of understanding regarding the need for continued medication adherence.
4. Choices A, B, and D are all appropriate and demonstrate good understanding of antidepressant treatment.
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The healthcare provider is providing care to a client with a tracheostomy. Which action should the healthcare provider take to prevent tracheostomy complications?
- A. Use sterile technique when performing tracheostomy care.
- B. Suction the tracheostomy tube every hour.
- C. Keep the tracheostomy tube cuff inflated at all times.
- D. Change the tracheostomy ties daily.
Correct Answer: A
Rationale: The correct answer is A: Use sterile technique when performing tracheostomy care. This is crucial to prevent infections that can lead to complications. Sterile technique helps minimize the risk of introducing harmful pathogens into the tracheostomy site. Using clean rather than sterile technique can increase the client's risk of infection.
Choice B is incorrect because suctioning the tracheostomy tube every hour can lead to mucosal damage and increase the risk of infection. Choice C is incorrect because keeping the tracheostomy tube cuff inflated at all times can cause pressure ulcers and damage the trachea. Choice D is incorrect because changing the tracheostomy ties daily is unnecessary and can increase the risk of dislodging the tracheostomy tube, leading to complications.
A healthcare professional is preparing to administer digoxin 0.25 mg PO daily. The amount available is digoxin 0.125 mg tablets. How many tablets should the healthcare professional administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
- A. 1
- B. 2
- C. 3
- D. 4
Correct Answer: B
Rationale: The correct answer is B: 2 tablets. To administer 0.25 mg of digoxin daily using 0.125 mg tablets, the healthcare professional should give 2 tablets. Each tablet is 0.125 mg, so 2 tablets will equal 0.25 mg, which is the required dose. The other choices are incorrect because administering 1 tablet would only provide 0.125 mg (half the required dose), administering 3 tablets would provide 0.375 mg (exceeding the required dose), and administering 4 tablets would provide 0.5 mg (double the required dose). Thus, the correct answer is to administer 2 tablets to achieve the prescribed 0.25 mg dose.
A client returns to the unit after a neck dissection. The surgeon placed a Jackson-Pratt drain in the wound. When assessing the wound drainage over the first 24 postoperative hours, what finding would prompt the nurse to notify the health care provider immediately?
- A. Presence of small blood clots in the drainage
- B. 60 mL of milky or cloudy drainage
- C. Spots of drainage on the dressings surrounding the drain
- D. 120 mL of serosanguinous drainage
Correct Answer: B
Rationale: The correct answer is B: 60 mL of milky or cloudy drainage. This finding could indicate the presence of an infection, which is a serious complication post-neck dissection. Milky or cloudy drainage may contain pus, indicating the need for immediate intervention to prevent further complications.
A: Presence of small blood clots in the drainage is relatively common and may not necessarily indicate a problem unless there are large clots or excessive bleeding.
C: Spots of drainage on the dressings surrounding the drain are expected and do not necessarily warrant immediate notification unless there is excessive leakage.
D: 120 mL of serosanguinous drainage is within the expected range for the first 24 hours postoperatively and may not be a cause for immediate concern unless there are other symptoms present.
The nurse is providing an educational workshop about coronary artery disease (CAD) and its risk factors. The nurse explains to participants that CAD has many risk factors, some that can be controlled and some that cannot. What risk factors should the nurse list that can be controlled or modified?
- A. Gender, obesity, family history, and smoking
- B. Inactivity, stress, gender, and smoking
- C. Cholesterol levels, hypertension, and smoking
- D. Stress, family history, and obesity
Correct Answer: C
Rationale: The correct answer is C because cholesterol levels, hypertension, and smoking are modifiable risk factors for CAD. High cholesterol levels can be controlled through diet and medication. Hypertension can be managed through lifestyle changes and medication. Smoking is a behavior that can be modified.
A is incorrect because gender and family history are non-modifiable risk factors. Obesity can be controlled but is not listed in the correct answer.
B is incorrect because inactivity and stress are modifiable risk factors, but gender is not modifiable.
D is incorrect because stress and family history are non-modifiable risk factors, and obesity is not listed in the correct answer.
A client's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn disease, rather than ulcerative colitis, as the cause of the client's signs and symptoms?
- A. A pattern of distinct exacerbations and remissions
- B. Severe diarrhea
- C. An absence of blood in stool
- D. Involvement of the rectal mucosa
Correct Answer: C
Rationale: The correct answer is C: An absence of blood in stool. This suggests Crohn's disease over ulcerative colitis because Crohn's can involve any part of the GI tract and may not always present with blood in stool, in contrast to ulcerative colitis which typically involves the rectum and almost always presents with blood in stool due to continuous inflammation in the colon. Choices A, B, and D are more commonly associated with ulcerative colitis, which typically presents with a pattern of exacerbations and remissions, severe diarrhea, and rectal mucosal involvement.