Nokea
A depressed patient who is taking a tricyclic antidepressant tells the nurse, "I don't think I can keep taking these pills. They make me very dizzy, especially when I stand up." The best nursing response is:
- A. That is annoying, but it is something most patients are able to learn to live with as time goes on. You'll get used to the medicine's side effects.
- B. The medicine can slow the body's adjustment of blood pressure when changing position; drinking more fluids and changing position slowly can help.
- C. Compared to the problems caused by the depression, it seems like a relatively small annoyance to have to put up with.
- D. All medicines have side effects, and this one is relatively mild. It could be that your depression is causing you to think negatively about the medicine.
Correct Answer: B
Rationale: The correct answer is B because tricyclic antidepressants can cause orthostatic hypotension leading to dizziness upon standing. Advising the patient to drink more fluids and change positions slowly can help alleviate this symptom. Choice A minimizes the patient's concern, which is not therapeutic. Choice C diminishes the patient's experience and feelings. Choice D dismisses the patient's symptoms and attributes them solely to the patient's negative thinking, which is not appropriate.
You may also like to solve these questions
Which nursing diagnosis is most appropriate for a patient with bulimia nervosa who engages in frequent purging behaviors?
- A. Ineffective coping related to inability to control impulses.
- B. Risk for injury related to electrolyte imbalances.
- C. Imbalanced nutrition: less than body requirements related to food refusal.
- D. Disturbed body image related to fear of weight gain.
Correct Answer: B
Rationale: The correct answer is B: Risk for injury related to electrolyte imbalances. Patients with bulimia nervosa who engage in frequent purging behaviors are at risk for electrolyte imbalances due to loss of potassium, sodium, and other essential minerals. This can lead to serious complications such as cardiac arrhythmias and organ damage. Monitoring and addressing electrolyte imbalances is crucial in the care of these patients to prevent potential harm.
A: Ineffective coping related to inability to control impulses is not the most appropriate diagnosis as it does not directly address the immediate risk of electrolyte imbalances in this scenario.
C: Imbalanced nutrition: less than body requirements related to food refusal is not the most appropriate diagnosis as the primary concern in bulimia nervosa with purging behaviors is the risk of electrolyte imbalances, not necessarily inadequate food intake.
D: Disturbed body image related to fear of weight gain is not the most appropriate diagnosis as it does not address the immediate physical health risks
A patient diagnosed with schizophrenia has had multiple relapses. The patient usually responds quickly to antipsychotic medication but soon discontinues the medication. Discharge plans include follow-up at the mental health center, group home placement, and a psychosocial day program. Which strategy should apply as the patient transitions from hospital to community?
- A. Administer a second-generation antipsychotic to help negative symptoms.
- B. Use a quick-dissolving medication formulation to reduce checking.
- C. Prescribe a long-acting intramuscular antipsychotic medication.
- D. Involve the patient in decisions about which medication is best.
Correct Answer: D
Rationale: Involving the patient in medication decisions (D) builds trust and alliance, key to adherence. Other options (A, B, C) are useful but secondary to establishing this foundation.
According to the map showing deaths resulting from poor air quality worldwide, which regions of the world have the poorest air quality?
- A. Brazil
- B. China
- C. Canada
- D. Australia
Correct Answer: B
Rationale: China has some of the poorest air quality globally due to industrial pollution and urbanization, as shown in air quality death maps.
When assessing the elderly for depression, the nurse may find that a depressed person over 70 years of age without a medical diagnosis, may have the following symptoms of depression (Select one tha does not apply):
- A. Aches
- B. Pains
- C. Constipation
- D. One-sided weakness
Correct Answer: D
Rationale: These symptoms (A, B, C, E) can be confused with other conditions like electrolyte imbalance or dementia, but are common physical manifestations of depression in the elderly. One-sided weakness (D) is more specific to stroke, not depression.
A 14-year-old female comes into clinic for a medical certificate once a week for multiple complaints of chest pain and abdominal pain. The complaints are non-specific, and her physical examination is normal. She is quiet with poor eye contact. She states the pain is worse on school days. Her mother is concerned that her daughter is being bullied but won't talk to her. Her mother is also worried that her complaints represent an undiagnosed medical condition. The next best step in management is:
- A. Referral to tertiary hospital to rule out organic cause
- B. HEADSS or other psychosocial screening
- C. Referral for counselling
- D. Reassurance that nothing is wrong
Correct Answer: B
Rationale: HEADSS screening assesses psychosocial factors (e.g., bullying, stress) that may underlie somatic complaints, making it the best next step before referral or reassurance.