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A client with a history of depression is prescribed citalopram (Celexa). The nurse should instruct the client to:
- A. Report signs of serotonin syndrome.
- B. Take the medication at bedtime.
- C. Avoid high-fiber foods.
- D. Stop the medication if mood improves.
Correct Answer: A
Rationale: Citalopram can cause serotonin syndrome, requiring monitoring for agitation and tremors.
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A client with a history of bipolar disorder is prescribed carbamazepine (Tegretol). The nurse should monitor the client for which of the following side effects?
- A. Weight loss.
- B. Agranulocytosis.
- C. Hyperglycemia.
- D. Dry skin.
Correct Answer: B
Rationale: Carbamazepine can cause agranulocytosis, requiring regular monitoring of white blood cell counts.
The nurse notes that the primary health care provider has written a prescription for prednisone for a client. The nurse contacts the primary health care provider about revision of the client's medication plan if which medication is noted on the client's medication record?
- A. Furosemide
- B. Oxycodone
- C. Acetaminophen
- D. Acetylsalicylic acid
Correct Answer: D
Rationale: Prednisone, a glucocorticoid, is irritating to the gastrointestinal (GI) tract, which could be worsened by the use of other products that have the same side effect. Therefore, products such as aspirin (acetylsalicylic acid) and nonsteroidal antiinflammatory drugs are not used during corticosteroid therapy.
The nurse walks into the room of a client who has a 'do not resuscitate' order and finds the client without a pulse, respirations, or blood pressure. What is the most appropriate action?
- A. Stay in the room and notify the nursing team for assistance.
- B. Push the emergency alarm to call a code.
- C. Dial the hospital phone number for a code.
- D. Pull the curtain and leave the room.
Correct Answer: D
Rationale: For a DNR client, no resuscitation is performed. The nurse should respectfully leave the room after ensuring privacy, notifying the team as needed for post-mortem care.
A 4-year-old child is admitted with dehydration due to gastroenteritis. Which assessment finding indicates severe dehydration?
- A. Dry mucous membranes
- B. Decreased urine output
- C. Sunken fontanelles
- D. Tachycardia
Correct Answer: C
Rationale: Sunken fontanelles in a young child are a sign of severe dehydration, indicating significant fluid loss requiring urgent rehydration.
Which of the following is an effective security plan that you may most likely want to consider for implementation within your facility?
- A. Training all nurses to serve as a part of a security response team
- B. Training all clerical staff to be a part of a security response team
- C. The restriction of visitors in a special care area
- D. Bar coded client identification bands to insure proper identification
Correct Answer: C,D
Rationale: Restricting visitors in special care areas and using bar-coded client identification bands are effective security measures to enhance safety and protect client identity, respectively.