Nokea
A patient with depression is prescribed fluoxetine. What is an important side effect for the nurse to monitor?
- A. Weight gain
- B. Bradycardia
- C. Dry mouth
- D. Suicidal thoughts
Correct Answer: D
Rationale: The correct answer is D: Suicidal thoughts. When a patient with depression is prescribed fluoxetine, there is a risk of increased suicidal thoughts, especially in the initial weeks of treatment. This is important for the nurse to monitor because it can lead to serious consequences. Weight gain (A) is a common side effect of fluoxetine but not as critical to monitor as suicidal thoughts. Bradycardia (B) and dry mouth (C) are not common side effects of fluoxetine and are less relevant to monitor in this scenario. Monitoring for suicidal thoughts is crucial for patient safety.
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What is the primary action of amlodipine when prescribed to a patient with hypertension?
- A. Increase heart rate
- B. Reduce blood pressure
- C. Lower cholesterol levels
- D. Decrease blood sugar levels
Correct Answer: B
Rationale: The primary action of amlodipine is to reduce blood pressure by relaxing and dilating blood vessels, leading to improved blood flow and lower blood pressure. This is achieved by blocking calcium channels in the blood vessels. Increasing heart rate (A), lowering cholesterol levels (C), and decreasing blood sugar levels (D) are not the primary actions of amlodipine and are not directly related to its mechanism of action in treating hypertension.
A patient with chronic heart failure is prescribed carvedilol. What is the primary purpose of this medication?
- A. Increase cardiac output
- B. Reduce fluid retention
- C. Decrease heart rate
- D. Lower blood pressure
Correct Answer: C
Rationale: The correct answer is C: Decrease heart rate. Carvedilol is a beta-blocker that works by blocking the beta-adrenergic receptors in the heart, leading to a decrease in heart rate. This helps reduce the workload of the heart and improve its efficiency in patients with heart failure. Choice A is incorrect because carvedilol may not necessarily increase cardiac output directly. Choice B is incorrect because carvedilol focuses more on improving heart function rather than directly reducing fluid retention. Choice D is incorrect because while carvedilol may lower blood pressure as a secondary effect, its primary purpose in heart failure is to improve cardiac function by decreasing heart rate.
A client with a history of peptic ulcer disease is admitted with severe abdominal pain. Which assessment finding should the nurse report to the healthcare provider immediately?
- A. Bowel sounds active in all quadrants.
- B. Blood pressure of 110/70 mm Hg.
- C. Rigid, board-like abdomen.
- D. Heart rate of 90 beats per minute.
Correct Answer: C
Rationale: The correct answer is C: Rigid, board-like abdomen. This finding suggests peritonitis, a serious complication of peptic ulcer disease, requiring immediate medical intervention. A: Active bowel sounds are expected. B: Blood pressure is within normal range. D: Heart rate is slightly elevated but not a critical finding. In summary, a rigid abdomen indicates peritonitis and requires urgent attention compared to the other choices.
A patient with chronic pain is prescribed gabapentin. What is the primary purpose of this medication?
- A. Relieve neuropathic pain
- B. Reduce inflammation
- C. Enhance opioid analgesia
- D. Suppress cough
Correct Answer: A
Rationale: The correct answer is A: Relieve neuropathic pain. Gabapentin is commonly used to treat neuropathic pain by stabilizing electrical activity in the brain and nervous system. It is effective in conditions such as diabetic neuropathy and postherpetic neuralgia. Choice B is incorrect because gabapentin does not have anti-inflammatory properties. Choice C is incorrect as gabapentin does not enhance opioid analgesia, but it can be used in conjunction with opioids for pain management. Choice D is incorrect as gabapentin is not indicated for cough suppression.
When should the charge nurse intervene based on the observed behavior?
- A. Two staff members are overheard talking about a cure for AIDS outside a client's room.
- B. A hospital transporter is reading a client's history and physical while waiting for an elevator.
- C. A UAP tells a client, 'It's hard to quit drinking but Alcoholics Anonymous helped me.'
- D. Two visitors are discussing a hospitalized client's history of drug abuse in the visitor's lounge.
Correct Answer: B
Rationale: The correct answer is B because it violates patient confidentiality. Reading a client's history and physical in a public area breaches the client's privacy rights. The other choices do not directly compromise patient confidentiality. A involves discussing a cure for AIDS, which is not a breach of confidentiality. C involves sharing personal experiences with the client, and D involves discussing a client's history of drug abuse in a visitor's lounge, which may not be overheard by the client or staff directly involved in the client's care.