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A client with panic disorder is prescribed sertraline (Zoloft). What is the most important information for the nurse to provide?
- A. You should take this medication at the same time every day.
- B. It may take several weeks for you to feel the full effect.
- C. This medication may cause a significant increase in appetite.
- D. You may experience dizziness, so avoid driving.
Correct Answer: B
Rationale: The correct answer is B. SSRIs like sertraline may take several weeks to reach their full therapeutic effect, so it's important to inform the client to be patient with the treatment. Choice A is not the most crucial information regarding sertraline. Choice C is not a common side effect of sertraline. Choice D is important but not as crucial as informing about the delayed onset of action.
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An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for the past 12 days. Which assessment finding requires immediate follow-up?
- A. Describes life as without purpose.
- B. Exhibits an increase in sweating.
- C. States is often fatigued and drowsy.
- D. Complains of nausea and loss of appetite.
Correct Answer: A
Rationale: The correct answer is A. Expressing that life is without purpose can indicate deepening depression or suicidal ideation, which requires immediate attention. While sweating, fatigue, drowsiness, nausea, and loss of appetite can be side effects of duloxetine (Cymbalta), they do not indicate the same level of urgency as a statement suggesting deepening depression or suicidal ideation.
An LPN/LVN is caring for a suicidal client. The appropriate nursing intervention in dealing with this client is to:
- A. Demonstrate confidence in the client's ability to deal with stressors
- B. Provide hope and reassurance that the problems will resolve themselves
- C. Display an attitude of detachment, confrontation, and efficiency
- D. Provide authority, action, and participation
Correct Answer: D
Rationale: When caring for a suicidal client, providing authority, taking action, and encouraging the client's participation in their care are essential. Choice A is incorrect as it may not be sufficient for the critical situation of a suicidal client. Choice B, while offering hope, may not address the immediate risk of harm. Choice C's attitude of detachment and confrontation can be counterproductive in establishing trust and rapport with the client. Therefore, the most appropriate intervention is to provide authority, take action to ensure safety, and involve the client in the care process.
A client with major depressive disorder is started on fluoxetine (Prozac). What should the nurse include in the client's discharge teaching?
- A. It may take 4-6 weeks for the medication to be effective.
- B. You should take this medication at bedtime.
- C. Avoid consuming dairy products while taking this medication.
- D. You can stop taking the medication once you feel better.
Correct Answer: A
Rationale: The correct answer is A: "It may take 4-6 weeks for the medication to be effective." SSRIs like fluoxetine typically take 4-6 weeks to reach their full effect, so clients should be informed to expect a gradual improvement in symptoms. Choice B is incorrect because fluoxetine is usually taken in the morning to prevent sleep disturbances. Choice C is incorrect as there is no specific need to avoid consuming dairy products while taking fluoxetine. Choice D is incorrect because clients should never stop taking antidepressants abruptly, as it can lead to withdrawal symptoms and worsening of the condition.
The LPN/LVN is caring for a client who has been prescribed lithium carbonate. What is the most important instruction for the nurse to provide?
- A. Take the medication with food to avoid stomach upset.
- B. Do not change your salt intake while on this medication.
- C. Drink plenty of water and maintain a consistent salt intake.
- D. Avoid excessive intake of caffeine while on this medication.
Correct Answer: B
Rationale: The most important instruction for a client prescribed lithium carbonate is not to change their salt intake. Alterations in sodium levels can impact lithium levels, leading to an increased risk of toxicity. Choice A is not crucial for lithium carbonate administration. While hydration is essential, maintaining a consistent salt intake is more critical than just increasing water intake (Choice C). Although caffeine can interact with lithium, it is not as important as maintaining a consistent salt intake (Choice D).
The client with schizophrenia believes the news commentator is her lover and speaks to her. What is the best response for the nurse to make?
- A. What do you believe the news commentator said to you?
- B. Let's switch to a different news channel.
- C. Is the news commentator planning to harm you or others?
- D. The news commentator is not communicating with you.
Correct Answer: A
Rationale: The correct response is to ask the client what she believes the news commentator said, as it helps the nurse assess the client's perception and delve into her delusions without being confrontational. Choice B is not helpful in addressing the client's delusions. Choice C jumps to conclusions about potential harm without assessing the client's beliefs. Choice D is dismissive and does not address the client's reality.