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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 caring for several 70 to 80 year-old clients on bed rest. What is the most important measure to prevent skin breakdown?
- A. Massage legs frequently
- B. Frequent turning
- C. Moisten skin with lotions
- D. Apply moist heat to reddened areas
Correct Answer: B
Rationale: Frequent turning. Frequent turning will prevent skin breakdown by relieving prolonged pressure on any one area.
The primary nursing diagnosis for a client with congestive heart failure with pulmonary edema is
- A. Pain
- B. Impaired gas exchange
- C. Cardiac output altered: decreased
- D. Fluid volume excess
Correct Answer: C
Rationale: Cardiac output altered: decreased. Increasing cardiac output is the primary goal of therapy, improving comfort and respiratory status.
The RN charge nurse hands the LPN/LVN a syringe filled with medication that the RN has just drawn and asks the LPN/LVN to administer this to a client. How should the LPN/LVN respond?
- A. Do as requested by the charge nurse
- B. Ask the charge nurse what the medication is and then administer it
- C. Ask the charge nurse what the medication is, check the order, and then administer it
- D. Refuse to administer the medication
Correct Answer: C
Rationale: Verifying the medication and checking the order ensures safe administration, adhering to medication safety protocols. Blind administration or refusal is unsafe or uncooperative.
While collecting data from pregnant clients in the obstetric clinic, the nurse should alert the health care provider to see which client first?
- A. First-trimester client who reports frequent nausea and vomiting
- B. Second-trimester client with dysuria and urinary frequency
- C. Second-trimester client with obesity who reports decrease in fetal movement
- D. Third-trimester client with right upper quadrant pain and nausea
Correct Answer: C
Rationale: Decreased fetal movement in the second trimester suggests potential fetal distress, requiring urgent evaluation. Nausea, UTI symptoms, and third-trimester pain are concerning but less immediately critical.
The nurse understands that which of these body substances are modes of transmission for hepatitis B? Select all that apply.
- A. Blood
- B. Feces
- C. Semen
- D. Urine
- E. Vaginal secretions
Correct Answer: A,C,E
Rationale: Hepatitis B is transmitted via blood, semen, and vaginal secretions. Feces and urine are not significant transmission modes.