Nokea
Escitalopram is prescribed for a 16-year-old adolescent client who is clinically depressed. Five days later, the parent tells the practical nurse (PN) that the drug is not working because their child is not feeling any better. Which explanation should the PN provide?
- A. It takes 1 to 4 weeks for antidepressant medications to become effective.
- B. The dosage may need to be increased; I will contact your health care provider.
- C. Depression is difficult to treat with drugs alone. Therapy sessions would enhance their effectiveness.
- D. Based on your child's response to this drug, the health care provider is reviewing your medication regimen.
Correct Answer: A
Rationale: Antidepressant medications typically require 1 to 4 weeks to reach their full therapeutic effect. It is crucial to educate the family that during the initial week of treatment, the child may experience heightened anxiety. Therefore, it is important to wait for the medication to take its full course before assessing its effectiveness.
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The healthcare provider has prescribed an influenza vaccine for a 74-year-old client before discharge. Which client condition would prompt the practical nurse to consult with the charge nurse rather than administer the vaccine?
- A. History of congestive heart failure
- B. History of an egg allergy
- C. History of pneumococcal vaccination
- D. History of end-stage renal disease
Correct Answer: B
Rationale: The correct answer is B: History of an egg allergy. The influenza vaccine may contain a small amount of egg protein. According to the CDC, individuals with a severe allergy to any component of the vaccine, including egg protein, should not receive the influenza vaccine. Therefore, if the client has a history of an allergy to eggs, the practical nurse should not administer the vaccine and consult with the charge nurse for further guidance, as it is a contraindication. The other conditions listed do not require consultation before administering the influenza vaccine.
A client with chronic heart failure is prescribed spironolactone. The nurse should monitor for which potential side effect?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hypernatremia
- D. Hyponatremia
Correct Answer: A
Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to an excess of potassium in the body, resulting in hyperkalemia. This side effect is important to monitor in clients taking spironolactone, especially those with chronic heart failure, as hyperkalemia can lead to serious cardiac complications.
When should a client receiving insulin lispro administer this medication?
- A. Before meals
- B. After meals
- C. At bedtime
- D. Before sleep
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with a diagnosis of bipolar disorder is prescribed valproate. The nurse should monitor for which potential adverse effect?
- A. Weight gain
- B. Hair loss
- C. Hyperglycemia
- D. Hypoglycemia
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The practical nurse administers lactulose to a client. Which client outcome would indicate a therapeutic response?
- A. An increase in urine output
- B. Two to three soft stools per day
- C. Absence of nausea
- D. Decreased serum potassium
Correct Answer: B
Rationale: Lactulose is a type of laxative that works by preventing the absorption of ammonia in the colon, leading to increased water absorption in the stool and softening of the stool. The therapeutic response to lactulose is indicated by the passage of two to three soft stools per day, showing that the medication is effectively promoting bowel movements.