Nokea
The client is started on citalopram for treatment of depression. Which information is most important for the nurse to include when teaching the client?
- A. Activity levels should be increased to include a daily exercise routine.
- B. If sexual side effects become unbearable, consult your health care provider.
- C. Taking St. John's wort with your citalopram can enhance its effectiveness.
- D. Take your blood pressure every morning and report Ascertain any significant changes.
Correct Answer: B
Rationale: Sexual dysfunction is a common side effect associated with the use of SSRIs; the client taking citalopram (Celexa), an SSRI, should consult the HCP if having unbearable sexual side effects.
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The LPN is caring for a client newly diagnosed with HIV. Which statement made by the client regarding antiretroviral therapy (ART) would require correction from the nurse?
- A. If I start ART and use condoms, I'm less likely to transmit HIV to my partner.
- B. I can still use ART even though I am Hepatitis C positive.
- C. I will need to be on ART indefinitely.
- D. I know I will need to come back for blood draws so that I can begin ART when my CD4 count is over 1,000 cells/mm3.
Correct Answer: D
Rationale: The World Health Organization (WHO) recommends making treatment for those with a CD4 count of ≤ 350 cells/mm3 a priority, as early intervention can help delay disease progression. Studies have shown that ART can reduce HIV transmission to sexual partners by up to 96%. Conditions such as pregnancy and Hepatitis B and C increase the need to initiate therapy sooner and are in no way contraindicated. ART does not cure HIV, but to maintain viral suppression, it should be continued indefinitely.
The severely depressed client tells the nurse, “I don't need these antidepressants; they're too expensive! I'm going to use St. John's wort instead.†Which is the most appropriate response by the nurse?
- A. It would be a safe alternative, especially if you need to watch your finances.
- B. What about taking St. John's wort and an antidepressant for greater effectiveness?
- C. St. John's wort may cost less, but it has not been shown to improve severe depression.
- D. I have some information showing the effective use of St. John's wort. Let's go over it.
Correct Answer: C
Rationale: St. John's wort has not been clinically proven effective for severe depression.
The newly hospitalized client admits using heroin 8 hours ago. Which assessment findings, if observed in the client, should the nurse associate with heroin withdrawal?
- A. Mental confusion, drowsiness, and hypotension
- B. Dysphoric mood, pupillary dilation, and sweating
- C. Pinpoint pupils, constipation, and urinary retention
- D. No withdrawal signs until 2 to 3 days have passed
Correct Answer: B
Rationale: Dysphoric mood, pupillary dilation, and sweating are signs of heroin withdrawal. Heroin is an opioid.
The LPN is teaching a first-time mother about breastfeeding her newborn. Which statement, if made by the mother, would reflect that the teaching had been successful?
- A. My baby should be having at least 4-6 wet diapers a day until 1 month.
- B. It's nice that breastfed babies eat a bit less than formula fed babies.
- C. My baby should be nursing 8-12 times a day during this period.
- D. I'm a little nervous about my milk coming in tomorrow. I've heard it's uncomfortable.
Correct Answer: C
Rationale: Newborns should be nursing 8-12 times during the newborn period. Until a mother's milk comes in, babies typically have a wet diaper count that corresponds to the number of days since their birth (one wet diaper for a 1-day-old baby, and so on). Once they are getting milk and not colostrum, infants should have 4-6 wet diapers a day. A mother's milk usually comes in 3-4 days after the initial colostrum stage. Breast milk is digested faster than formula, so breastfed babies typically eat more frequently.
The nurse is providing instructions to the client taking alprazolam. Which substances should the client be instructed to avoid? Select all that apply.
- A. Alcohol
- B. Caffeine
- C. Narcotics
- D. Antioxidants
- E. Antihistamines
- F. Antidepressants
Correct Answer: A,C,E,F
Rationale: Alcohol, narcotics, antihistamines, and antidepressants can increase CNS side effects when taken with alprazolam (Xanax).