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A depressed patient is receiving imipramine (Tofranil) 300 mg daily. Which side effect requires seeking medical attention?
- A. Dry mouth
- B. Blurred vision
- C. Nasal congestion
- D. Urinary retention
Correct Answer: D
Rationale: The correct answer is D: Urinary retention. Imipramine is known to cause anticholinergic side effects, such as urinary retention. This side effect is serious and requires immediate medical attention to prevent complications like bladder distention or urinary tract infections. Dry mouth and blurred vision are common but less urgent side effects of imipramine, while nasal congestion is not typically associated with this medication. Thus, urinary retention stands out as the side effect requiring immediate medical attention among the choices provided.
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A nurse caring for a patient with Alzheimer disease can anticipate that the family will most likely need information about:
- A. antimetabolites.
- B. benzodiazepines.
- C. immunosuppressants.
- D. acetylcholinesterase inhibitors.
Correct Answer: D
Rationale: The correct answer is D: acetylcholinesterase inhibitors. Patients with Alzheimer's disease often benefit from this type of medication to help improve cognitive function. The family would need information on this to understand the treatment plan. Antimetabolites (A), benzodiazepines (B), and immunosuppressants (C) are not typically used in the treatment of Alzheimer's disease and would not be relevant for the family to know about in this context.
When planning inpatient psychotherapeutic activities for a patient who has antisocial personality disorder, the psychiatric-mental health nurse:
- A. focuses on group, rather than individual, therapy
- B. provides a permissive atmosphere, so the patient feels a sense of control
- C. provides an organized, structured environment
- D. recognizes that the disorder is characterized by social withdrawal
Correct Answer: C
Rationale: A structured environment sets clear boundaries, countering manipulative tendencies common in antisocial personality disorder.
Behavioral problems in which the person exhibits symptoms suggesting physical disease or injury, but for which there is no identifiable cause, are called
- A. mood disorders
- B. schizophrenia
- C. organic brain pathologies
- D. somatoform disorders
Correct Answer: D
Rationale: Somatoform disorders feature physical complaints without medical explanation.
A client with anorexia nervosa engages in manipulative behavior. She tells the nurse, 'I can't get weighed this morning, because I drank a glass of juice a few minutes before breakfast.' The best approach by the nurse would be:
- A. I'm pleased that you took in some calories.'
- B. We can get around this, if you'll eat a doughnut, too.'
- C. The rule is 'weigh before eating'; now we have to put it off until tomorrow.'
- D. This is weight day. Please step on the scale.'
Correct Answer: D
Rationale: Step 1: The correct answer is D because it sets clear boundaries and enforces consistency by reminding the client of the established protocol.
Step 2: By stating "This is weight day. Please step on the scale," the nurse maintains the structure and accountability in the treatment plan.
Step 3: This response avoids reinforcing manipulative behavior and emphasizes the importance of following the agreed-upon rules for accurate monitoring.
Step 4: Other choices like A may inadvertently validate the manipulation, B suggests giving in to the client's avoidance tactic, and C delays the weighing without addressing the manipulation directly.
An 85-year-old has difficulty walking after a knee replacement. The patient tells the nurse, 'It's awful to be old. Every day is a struggle. No one cares about old people.' Select the nurse's best response.
- A. Everyone here cares about old people. That's why we work here.
- B. It sounds like you're having a difficult time. Tell me about it.
- C. Let's not focus on the negative. Tell me something good.
- D. You are still able to get around, and your mind is alert.
Correct Answer: B
Rationale: The correct answer is B because it shows empathy and encourages the patient to express their feelings. By saying "Tell me about it," the nurse acknowledges the patient's struggle and opens up the opportunity for the patient to share more about their feelings and concerns. This can help build a therapeutic relationship and provide emotional support.
Choice A is incorrect because it dismisses the patient's feelings by making a general statement about everyone caring without addressing the patient's specific concerns.
Choice C is incorrect because it invalidates the patient's emotions by suggesting to focus on positivity without addressing the patient's current distress.
Choice D is incorrect because it minimizes the patient's struggle by only focusing on physical abilities and cognitive function without addressing the emotional aspect of the patient's statement.