Nokea
In planning for a client's discharge, the nurse must know that the most serious risk for the client taking a tricyclic antidepressant is which of the following?
- A. Hypotension
- B. Narrow-angle glaucoma
- C. Seizures
- D. Suicide by overdose
Correct Answer: D
Rationale: Tricyclic antidepressants are potentially lethal in overdose, posing a significant suicide risk. Other side effects like hypotension and glaucoma are concerning but less severe.
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The nurse is assessing a patient suffering a head injury as a result of an altercation with two other individuals. The patient has difficulty accurately reporting the events of the altercation and appears very emotional during the assessment. The nurse suspects which part of the brain received the greatest amount of injury?
- A. Cerebrum
- B. Cerebellum
- C. Medulla
- D. Amygdala
Correct Answer: A
Rationale: The frontal lobes of the cerebrum control the organization of thought, body movement, memories, emotions, and moral behavior. The cerebellum is the center for coordination of movements and postural adjustments. The medulla contains vital centers for respiration and cardiovascular functions. The amygdala is involved in emotional arousal and memory.
The nurse is preparing a patient for an MRI scan of the head. The nurse should ask the patient.
- A. Have you ever had an allergic reaction to radioactive dye?
- B. Have you had anything to eat in the last 24 hours?
- C. Does your insurance cover the cost of this scan?
- D. Are you anxious about being in tight spaces?
Correct Answer: D
Rationale: The person undergoing an MRI must lie in a small, closed chamber and remain motionless during the procedure, which takes about 45 minutes. Those who feel claustrophobic or have increased anxiety may require sedation before the procedure. PET scans, not MRIs, require radioactive substances. Fasting is not required for brain imaging studies, and verifying insurance is not a primary nursing role.
A client who is taking paroxetine (Paxil) reports to the nurse that he has been nauseated since beginning the medication. Which of the following actions is indicated initially?
- A. Instruct the client to stop the medication for a few days to see if the nausea goes away.
- B. Reassure the client that this is an expected side effect that will improve with time.
- C. Suggest that the client take the medication with food.
- D. Tell the client to contact the physician for a change in medication.
Correct Answer: C
Rationale: Taking SSRIs like paroxetine with food usually eliminates nausea, making this the initial recommended action.
Which of the following medications rarely causes extrapyramidal side effects (EPS)?
- A. Ziprasidone (Geodon)
- B. Chlorpromazine (Thorazine)
- C. Haloperidol (Haldol)
- D. Fluphenazine (Prolixin)
Correct Answer: A
Rationale: Atypical antipsychotics like ziprasidone rarely cause EPS compared to first-generation antipsychotics like chlorpromazine, haloperidol, and fluphenazine.
The nurse knows that the client understands the rationale for dietary restrictions when taking MAOI when the client makes which of the following statements?
- A. I am now allergic to foods that are high in the amino acid tyramine such as aged cheese, organ meats, wine, and chocolate.
- B. Certain foods will cause me to have sexual dysfunction when I take this medication.
- C. Foods that are high in tyramine will reduce the medication's effectiveness.
- D. I should avoid foods that are high in the amino acid tyramine such as aged cheese, meats, and chocolate because this drug causes the level of tyramine to go up to dangerous levels.
Correct Answer: D
Rationale: MAOIs inhibit the enzyme that breaks down tyramine, leading to increased serum tyramine levels, which can cause severe hypertension and other symptoms. The correct statement reflects understanding of the need to avoid tyramine-rich foods to prevent dangerous reactions.