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The intervention that would be most appropriate of a male client develops orthostatic hypotension while taking amitriptyline (Elavil) is
- A. Consulting with the physician about substituting a different type of antidepressant
- B. Advising the client to sit up for 1 minute before getting out of bed
- C. Instructing the client to double the dosage until the problem resolves.
- D. Instruct the client to stop medication immediately
Correct Answer: B
Rationale: Advising the client to sit up slowly helps manage orthostatic hypotension, a common side effect of amitriptyline, by preventing sudden drops in blood pressure.
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A patient with bipolar disorder, mania, relapsed after discontinuing lithium. The health care provider prescribes lithium 600 mg BID and olanzapine (Zyprexa) 10 mg BID. What is the rationale for addition of olanzapine to the lithium regime? It will:
- A. Minimize the side effects of lithium.
- B. Bring hyperactivity under rapid control.
- C. Potentiate the antimanic action of lithium.
- D. Be used for long-term control of hyperactivity.
Correct Answer: B
Rationale: The correct answer is B: Bring hyperactivity under rapid control.
Rationale:
1. Olanzapine is an atypical antipsychotic known for its rapid onset of action in controlling manic symptoms, including hyperactivity.
2. Lithium alone may take time to reach therapeutic levels and show efficacy, while olanzapine can provide more immediate relief.
3. Combining olanzapine with lithium can address acute manic symptoms effectively and quickly.
4. Choice A is incorrect because olanzapine does not specifically minimize lithium's side effects.
5. Choice C is incorrect as olanzapine does not directly potentiate lithium's antimanic action.
6. Choice D is incorrect because olanzapine is typically used for acute symptom management rather than long-term control.
A client with a personality disorder asks the nurse, 'Is it true I have an inherited brain disorder?' The nurse replies, knowing that:
- A. There is proof that personality disorders are inherited
- B. All persons with personality disorders display brain abnormalities
- C. Individuals with personality disorders show an error in brain glucose metabolism
- D. Individuals with personality disorders manifest some biological markers
Correct Answer: D
Rationale: Rationale:
D is correct because individuals with personality disorders can manifest biological markers indicating a potential biological basis for the disorder. This does not imply that all individuals with personality disorders display brain abnormalities (B), have errors in brain glucose metabolism (C), or that there is definitive proof of inheritance (A). Biological markers suggest a potential biological component but do not guarantee inheritance or specific brain abnormalities.
A boy with a conduct disorder diagnosis would be most likely to have which symptom?
- A. Withdrawal
- B. Ritualistic behavior
- C. Class bully
- D. Class clown
Correct Answer: C
Rationale: A pattern of bullying is a common sign of conduct disorder. Responses A and B may reflect autism.
A man, aged 84 years, was stopped for going through a red light in a small town where he lives. He told the officer, 'It wasn't there yesterday.' He was unable to tell the officer his address and demonstrated labile mood, seeming pleasant one minute and angry the next. The officer took the man home to discuss his condition with the family and found that he has been wandering around the neighborhood, sometimes taking tools from people's garages, saying they belong to him. The family reluctantly agreed that he should go to the emergency department. What cardinal sign of Alzheimer's disease does this patient demonstrate?
- A. Agnosia.
- B. Apraxia.
- C. Aphasia.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Agnosia. Agnosia is the inability to recognize or interpret sensory information, such as objects, people, sounds, or shapes. In this case, the patient's inability to recognize the red light, his own address, and the ownership of tools indicates a problem with perception and recognition. This aligns with the symptoms of agnosia commonly seen in Alzheimer's disease.
Choices B and C are incorrect. Apraxia is the inability to perform purposeful movements, and aphasia is the loss of ability to understand or express speech. These symptoms are not the primary cardinal sign demonstrated by the patient in the scenario. Choice D, "None of the above," is also incorrect as the patient's symptoms align with the characteristics of agnosia.
What is the priority nursing intervention when caring for a patient with bulimia nervosa who has a history of purging?
- A. Provide emotional support and assist with stress management.
- B. Monitor vital signs and electrolyte levels closely.
- C. Encourage the patient to exercise regularly to prevent weight gain.
- D. Help the patient identify triggers for binge eating and purging behaviors.
Correct Answer: B
Rationale: The correct answer is B because monitoring vital signs and electrolyte levels closely is crucial in managing a patient with bulimia nervosa who has a history of purging. Purging can lead to electrolyte imbalances and dehydration, which can have serious consequences such as cardiac arrhythmias and electrolyte disturbances. By closely monitoring vital signs and electrolyte levels, nurses can quickly identify and intervene in case of any abnormalities, preventing potential life-threatening complications.
Choice A is incorrect because emotional support and stress management are important but not the priority when dealing with physical complications from purging. Choice C is incorrect because encouraging exercise may exacerbate the patient's unhealthy behaviors and should be approached cautiously. Choice D is incorrect because identifying triggers is important but not as immediate as monitoring vital signs and electrolyte levels in this situation.