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A nurse is teaching the parent of a school-age child who has ADHD and a prescription for atomoxetine 40 mg daily. Which of the following information should the nurse include in the teaching?
- A. Expect the child to gain weight while taking this medication
- B. Crush the medication and mix it with 120 mL (4 oz) of juice
- C. Therapeutic effects will occur within 24 hr of starting treatment
- D. Administer the medication before the child goes to school in the morning
Correct Answer: D
Rationale: The correct answer is D: Administer the medication before the child goes to school in the morning. Atomoxetine is a non-stimulant medication used to treat ADHD. Administering it in the morning allows for optimal absorption and effectiveness during the school day. This helps in improving the child's focus and attention span in a learning environment. Additionally, taking the medication in the morning helps in minimizing potential side effects such as insomnia. Choices A, B, and C are incorrect because weight gain is not a common side effect of atomoxetine, crushing the medication can alter its effectiveness, and therapeutic effects usually take a few weeks to manifest, not within 24 hours.
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A nurse is assessing a client who requires bupropion for smoking cessation. Which of the following findings in the client’s history should the nurse recognize as a contraindication for taking this medication?
- A. Seizures
- B. Anemia
- C. Migraines
- D. Asthma
Correct Answer: A
Rationale: The correct answer is A: Seizures. Bupropion is contraindicated in individuals with a history of seizures due to the potential to lower the seizure threshold. This can increase the risk of seizures occurring. Anemia (B), migraines (C), and asthma (D) are not contraindications for taking bupropion. Anemia and migraines are not directly related to the use of bupropion, and in some cases, bupropion may even help with migraines. Asthma, while a consideration, is not a contraindication for taking bupropion.
A nurse is providing teaching to a client who has schizophrenia and is prescribed risperidone. Which of the following instructions should the nurse include?
- A. Avoid direct sunlight
- B. Rise slowly from a sitting position
- C. Take the medication on an empty stomach
- D. Expect weight loss as a side effect
Correct Answer: B
Rationale: The correct answer is B: Rise slowly from a sitting position. This instruction is crucial because risperidone can cause orthostatic hypotension, leading to dizziness or fainting when standing up quickly. By rising slowly, the client can minimize the risk of falls. Avoiding direct sunlight (A) is not directly related to risperidone use. Taking the medication on an empty stomach (C) is not necessary for risperidone. Expecting weight loss (D) is not a common side effect of risperidone; in fact, weight gain is more common.
A nurse is caring for a client who has posttraumatic stress disorder related to military service. Which of the following actions should the nurse take?
- A. Encourage the client to suppress feelings of trauma
- B. Assign the same staff to care for the client each day
- C. Address the client in an authoritative manner
- D. Limit the amount of time spent with the client
Correct Answer: B
Rationale: The correct answer is B: Assign the same staff to care for the client each day. Consistency in care providers helps establish trust and a sense of safety for clients with PTSD. This familiarity can reduce anxiety and improve therapeutic rapport. Encouraging the client to suppress feelings of trauma (A) can be harmful as it may worsen symptoms. Addressing the client in an authoritative manner (C) can trigger feelings of threat. Limiting time spent with the client (D) can hinder the development of a therapeutic relationship.
A nurse is giving a presentation about intimate partner abuse for a community group. Which of the following statements by a group member indicates understanding of the teaching?
- A. Survivors of abuse often feel guilty
- B. Abusers often have high self-esteem
- C. The honeymoon stage of violence usually gets longer over time
- D. As abuse continues, victims become more determined to be independent
Correct Answer: A
Rationale: Correct Answer: A: Survivors of abuse often feel guilty
Rationale: This statement indicates understanding of the psychological impact of intimate partner abuse. Guilt is a common emotion experienced by survivors due to manipulation and blame from the abuser. It reflects the internalized self-blame and shame that many survivors struggle with.
Summary of other choices:
B: Abusers often have high self-esteem - Incorrect. Abusers typically have low self-esteem and use abuse as a way to exert power and control.
C: The honeymoon stage of violence usually gets longer over time - Incorrect. The honeymoon phase tends to decrease over time as abuse cycles escalate.
D: As abuse continues, victims become more determined to be independent - Incorrect. Victims often experience increased isolation and dependency on the abuser.
A nurse is caring for a client who has obsessive-compulsive disorder and engages in repeated handwashing. Which of the following actions should the nurse take?
- A. Encourage the client to stop washing hands
- B. Allow the client additional time to complete rituals
- C. Set strict time limits on compulsions
- D. Ignore the client’s compulsive behavior
Correct Answer: B
Rationale: The correct answer is B: Allow the client additional time to complete rituals. This approach is known as a harm reduction strategy in managing obsessive-compulsive disorder. By allowing the client additional time to complete rituals, the nurse can help reduce the client's anxiety and provide a sense of control. Encouraging the client to stop washing hands (A) may increase anxiety and worsen symptoms. Setting strict time limits on compulsions (C) can also increase anxiety and lead to distress. Ignoring the client's compulsive behavior (D) can be harmful as it may reinforce the behavior. It is important for the nurse to be supportive and understanding of the client's struggles while working towards more effective coping strategies.