Nokea
A client is started on doxepin hydrochloride (Sinequan) 75 mg PO tid. The nurse should recommend a change in the client's therapy if which of the following occurs?
- A. The client refuses to speak and sits quietly in the room.
- B. The client becomes excitable and develops tremors.
- C. The client refuses to eat breakfast.
- D. The client sleeps 18 hours a day.
Correct Answer: B
Rationale: doxepin HCL (Sinequan) is an antidepressant; signs of overdosage include excitability and tremors
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The nurse is caring for a client with a history of congestive heart failure.
- A. Which instruction is most important for a client with congestive heart failure?
- B. Weigh yourself daily at the same time.
- C. Take extra diuretics if you feel short of breath.
- D. Eat a high-sodium diet to maintain electrolytes.
- E. Avoid exercise to prevent cardiac strain.
Correct Answer: A
Rationale: Daily weight monitoring detects fluid retention early, a key indicator of worsening heart failure. Extra diuretics require medical orders, high-sodium diets worsen fluid retention, and exercise is encouraged within limits.
The nurse is caring for a client with a history of gastroesophageal reflux disease (GERD).
- A. Which instruction is most appropriate for a client with GERD?
- B. Eat large meals to reduce acid production.
- C. Lie down immediately after eating.
- D. Elevate the head of the bed during sleep.
- E. Avoid drinking water with meals.
Correct Answer: C
Rationale: Elevating the head of the bed during sleep prevents acid reflux by using gravity to keep stomach contents down. Large meals and lying down post-meal worsen reflux, and water is neutral.
The nurse is caring for a client with a history of hypothyroidism.
- A. Which symptom is expected in a client with untreated hypothyroidism?
- B. Weight loss and irritability.
- C. Cold intolerance and fatigue.
- D. Tachycardia and heat intolerance.
- E. Diarrhea and restlessness.
Correct Answer: B
Rationale: Cold intolerance and fatigue are classic symptoms of hypothyroidism due to slowed metabolism. Weight loss, tachycardia, and diarrhea are associated with hyperthyroidism.
The nurse is teaching a client about warfarin (Coumadin) therapy. Which of the following statements by the client indicates a need for further teaching?
- A. I will avoid contact sports while taking this medication.
- B. I will check with my doctor before taking any new medications.
- C. I will increase my intake of green leafy vegetables.
- D. I will report any unusual bleeding to my doctor.
Correct Answer: C
Rationale: green leafy vegetables are high in vitamin K, which can decrease the effectiveness of warfarin
The nurse is caring for clients in the hospital. Which of the following nursing activities BEST promotes rest for an elderly hospitalized client?
- A. Place a clock at the bedside.
- B. Restrict visitors so that the client is alone during the evening.
- C. Tell the client how to call for help if needed.
- D. Postpone explanation of further tests that the client will need.
Correct Answer: C
Rationale: elderly client who feels isolated and unable to obtain help if needed cannot rest properly