A female client is being treated for depression that has occurred secondary to a chronic cardiopulmonary condition. Which antidepressant would the nurse anticipate being prescribed for this client?
- A. Trazodone (Desyrel)
- B. Bupropion (Wellbutrin)
- C. Fluoxetine (Prozac)
- D. Amitriptyline (Elavil)
Correct Answer: C
Rationale: Fluoxetine (Prozac) (C), an SSRI, is often prescribed for depression in clients with cardiopulmonary conditions due to its favorable side effect profile and minimal cardiac impact. Trazodone (A) is sedating, bupropion (B) may increase seizure risk, and amitriptyline (D), a tricyclic, has significant cardiac side effects.
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A client has had a major stroke, and she is struggling to adjust to living with the consequent changes and permanent disabilities because of problems related to speech and mobility. The nurse is making a home visit and assesses the client closely based on the understanding that the client is at increased risk for which of the following?
- A. Bipolar I disorder
- B. Major depressive disorder
- C. Generalized anxiety disorder
- D. Posttraumatic stress disorder
Correct Answer: B
Rationale: Major depressive disorder (B) is a common risk following a major stroke due to the impact of speech and mobility impairments on quality of life. Bipolar disorder (A), anxiety (C), and PTSD (D) are less directly associated with stroke-related disability.
A client visits the clinic and complains of chronic pain in her leg as a result of a fall 6 months ago. Which of the following would be most important for the nurse to do first when developing the client?s plan of care?
- A. Acknowledge the client?s pain.
- B. Identify situations that increase the pain.
- C. Have the client rate her pain from 1 to 10.
- D. Review the client?s current medications.
Correct Answer: A
Rationale: Acknowledging the client?s pain (A) is the first step to build trust and validate the client?s experience, essential for effective care planning. Identifying pain triggers (B), rating pain (C), and reviewing medications (D) follow but are secondary to establishing rapport.
A 22-year-old college student was involved in an automobile accident that resulted in permanent cognitive and physical disability. The night of the accident, the client and his friends had been celebrating a friend?s birthday at a local bar. The friend who was celebrating a birthday had been driving, and he was killed during the accident. The client feels guilty about his friend?s death. Which of the following would be a priority assessment for this client?
- A. Risk for suicide
- B. Level of depression
- C. Social support systems
- D. Financial status
Correct Answer: A
Rationale: Risk for suicide (A) is the priority due to the client?s guilt and trauma from the accident, which increase suicidality in the context of new disabilities. Depression level (B), social support (C), and financial status (D) are important but secondary to ensuring safety.
A client visits the clinic and tells the nurse about experiencing chronic stress on the job for the past 3 months. When teaching the client about chronic stress, which of the following would the nurse include as a possible result?
- A. Lung disorders
- B. Renal disorders
- C. Infections
- D. Thyroid disorders
Correct Answer: C
Rationale: Chronic stress weakens the immune system, increasing susceptibility to infections (C). Lung (A), renal (B), and thyroid disorders (D) are less directly linked to chronic stress, though prolonged stress may exacerbate existing conditions.
After teaching a group of nursing students about the connections between mental health and medical disorders on clients and families, the instructor determines the need for additional teaching when the students identify which of the following as an effect?
- A. Increased motivation for self-care
- B. Prolonged hospitalization
- C. Delayed recovery
- D. Increased financial strain
Correct Answer: A
Rationale: Increased motivation for self-care (A) is not a typical effect of combined mental health and medical disorders; these conditions often reduce motivation. Prolonged hospitalization (B), delayed recovery (C), and increased financial strain (D) are recognized effects.
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