Nokea
A client with a history of depression is prescribed sertraline (Zoloft). The nurse should instruct the client to report which of the following side effects?
- A. Insomnia.
- B. Bradycardia.
- C. Hypotension.
- D. Weight loss.
Correct Answer: A
Rationale: Sertraline commonly causes insomnia, which should be reported to manage treatment.
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A client has nephrotic syndrome. To aid in the resolution of the client's edema, the physician orders 25% albumin. In addition to an absence of edema, the nurse should evaluate the client for which expected outcome?
- A. Crackles in the lung bases.
- B. Blood pressure elevation.
- C. Cerebral edema.
- D. Cool skin temperature in lower extremities.
Correct Answer: B
Rationale: Albumin increases oncotic pressure, pulling fluid into the vascular space, which may elevate blood pressure. Crackles, cerebral edema, or cool extremities would indicate complications.
A client with a history of chronic pain is prescribed gabapentin (Neurontin). The nurse should instruct the client to report which of the following side effects?
- A. Drowsiness.
- B. Hypertension.
- C. Hyperglycemia.
- D. Tachycardia.
Correct Answer: A
Rationale: Gabapentin commonly causes drowsiness, which should be reported to manage safety and dosing.
Which couple is at greatest risk for domestic violence?
- A. A couple which consists of a husband and wife both of whom are affected with Alzheimer's disease
- B. A poverty stricken couple without any healthcare resources in the community
- C. A pregnant woman and a husband who was physically abused as a young child
- D. A wealthy couple with feelings that they are immune from punishment and above the law
Correct Answer: C
Rationale: A history of childhood physical abuse is a significant risk factor for perpetrating domestic violence, as it may lead to learned behaviors or unresolved trauma. Pregnancy can also increase stress and vulnerability, further elevating the risk.
A client with a history of anxiety disorder is prescribed buspirone (BuSpar). The nurse should explain that this medication:
- A. Works immediately to reduce anxiety.
- B. May take 2-4 weeks to achieve full effect.
- C. Should be taken with grapefruit juice.
- D. Is addictive and requires tapering.
Correct Answer: B
Rationale: Buspirone typically takes 2-4 weeks to achieve its full anti-anxiety effect, unlike benzodiazepines.
A client with a history of heart failure is prescribed lisinopril (Prinivil). The nurse should monitor the client for which of the following adverse effects?
- A. Hyperkalemia.
- B. Hypotension.
- C. Weight loss.
- D. Tachycardia.
Correct Answer: A, B
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia and hypotension.