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The client admitted for inpatient treatment of an anxiety disorder has been taking fluoxetine for the past 9 months. The HCP prescribes a new antianxiety medication and discontinues fluoxetine. What is the nurse's most appropriate intervention?
- A. Monitor the client closely for dizziness and lethargy due to discontinuation syndrome.
- B. Teach the client relaxation measures to use while adjusting to the new antianxiety drug.
- C. Call the HCP to question whether fluoxetine should be iżtapered rather than discontinued.
- D. Reassure the client that there is little risk of adverse effects when discontinuing fluoxetine.
Correct Answer: D
Rationale: Because of its long half-life, there is a relatively low risk of adverse effects when discontinuing fluoxetine (Prozac). The client should be reassured and taught about the change of antianxiety medication.
You may also like to solve these questions
Around what age do children start to develop "stranger anxiety"?
- A. 9 months
- B. 6 months
- C. 3 months
- D. 12 months
Correct Answer: B
Rationale: By 6 months, children should be able to recognize familiar faces, and thus they are aware of strangers. Strangers may illicit anxiety.
Nursing care for a client undergoing chemotherapy includes assessment for signs of bone marrow depression. Which finding accounts for some of the symptoms related to bone marrow depression?
- A. erythrocytosis
- B. leukocytosis
- C. polycythemia
- D. thrombocytopenia
Correct Answer: D
Rationale: Thrombocytopenia is an abnormal decrease in the number of platelets, which results in bleeding tendencies. Erythrocytosis is an abnormal increase in the number of circulating red blood cells. Leukocytosis is an increase in the number of white blood cells in the blood. Polycythemia is also an excess of red blood cells and is a synonym for erythrocytosis. With chemotherapy there is a decrease in red and white blood cells, not an increase.
The best lab test to diagnose disseminated intravascular coagulation (DIC) is:
- A. platelet count
- B. protime (PT)
- C. partial thromboplastin time (PTT)
- D. D-dimer
Correct Answer: D
Rationale: The D-dimer test specifically detects fibrin degradation products, indicating DIC's characteristic clotting and fibrinolysis. Other tests are less specific.
The LPN is caring for a client admitted for acute pancreatitis. Which of these medications would be least appropriate for pain management?
- A. Tylenol
- B. Tramadol
- C. Codeine
- D. Morphine
Correct Answer: D
Rationale: Morphine is contraindicated for pain management in pancreatitis because it causes spasms in the Sphincter of Oddi.
The child weighing 20 kg is to receive ceftriaxone 2 g IVPB q12h and dexamethasone 3 mg IV-push q6h for 4 days to treat Haemophilus influenzae type b meningitis. The drug reference states that the usual dose of ceftriaxone is 100 mg/kg/dose with a maximum daily dose of 4 g. The recommended dose of dexamethasone for treating H. influenzae type b meningitis is 0.15 mg/kg q6h for 2 to 4 days. Based on the medications prescribed and these findings, which conclusion by the nurse is correct?
- A. The dose of ceftriaxone is too high.
- B. The dose of dexamethasone is too low.
- C. Both medications are safe to administer as prescribed.
- D. The ceftriaxone should be given before the dexamethasone.
Correct Answer: C
Rationale: A: The dose for ceftriaxone is correct (100 mg x 20 kg = 2000 mg; 1000 mg = 1 g; 2000 mg = 2 g). B: The dose of dexamethasone is correct (0.15 mg x 20 kg = 3 mg). C: The doses of ceftriaxone (Rocephin) and dexamethasone (Decadron) are at the recommended doses. D: An IV-push medication takes less time to administer than an IV piggyback (IVPB) medication. The dexamethasone should be administered first.