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The patient is taking antidepressant drug, Elavil. The spouse of the patient complains that the dosage of the drug needs to be increased because no improvement is noted. The patient has been taking the drug for the last 3 days and no improvement is noted.
The most appropriate nursing response would be:
- A. I will inform the physician about your concern.
- B. It may take 3 to 4 weeks for the drug to work.
- C. The drug should work right away.
- D. Possible drug resistant has developed.
Correct Answer: B
Rationale: Elavil, a tricyclic antidepressant, typically takes 3–4 weeks to show therapeutic effects.
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Most asthmatic attacks respond to Epinephrine (Adrenalin)
Most asthmatic attacks respond to Epinephrine (Adrenalin) and it may be used as a therapeutic agent in the treatment of some allergic conditions because it:
- A. Improves cardiac output due to its positive inotropic effect.
- B. Acts as a hypertensive agent elevating BP.
- C. Dilates the bronchi.
- D. Antagonizes histamine.
Correct Answer: C
Rationale: Epinephrine dilates bronchi, relieving bronchospasm in asthma and allergic reactions.
A nurse is caring for a client who had a closed reduction of a fractured right wrist followed by the application of a fiberglass cast 12 hours ago. Which finding requires the nurse's immediate attention?
- A. Capillary refill of fingers on right hand is 3 seconds
- B. Skin warm to touch and normally colored
- C. Client reports prickling sensation in the right hand
- D. Slight swelling of fingers of right hand
Correct Answer: C
Rationale: Client reports prickling sensation in the right hand. A prickling sensation is an indication of compartment syndrome and requires immediate action by the nurse. The other findings are normal for a client in this situation.
A 23-year-old woman at 32-weeks gestation is seen in the outpatient clinic. Which of the following findings, if assessed by the nurse, would indicate a possible complication?
- A. The client's urine test is positive for glucose and acetone.
- B. The client has 1+ pedal edema in both feet at the end of the day.
- C. The client complains of an increase in vaginal discharge.
- D. The client says she feels pressure against her diaphragm when the baby moves.
Correct Answer: A
Rationale: Positive urine glucose and acetone suggest gestational diabetes mellitus (GDM), which can lead to placental insufficiency and fetal complications, requiring immediate evaluation. Pedal edema (B), increased vaginal discharge (C), and diaphragmatic pressure (D) are common in late pregnancy and not typically concerning unless accompanied by other symptoms.
The nurse is teaching a client about the difference between tardive dyskinesia (TD) and neuroleptic malignant syndrome (NMS). Which statement is true with regards to tardive dyskinesia?
- A. TD develops within hours or years of continued antipsychotic drug use in people under 20 and over 30
- B. It can occur in clients taking antipsychotic drugs longer than 2 years
- C. Tardive dyskinesia occurs within minutes of the first dose of antipsychotic drugs and is reversible
- D. TD can easily be treated with anticholinergic drugs
Correct Answer: B
Rationale: Tardive dyskinesia is an extrapyramidal side effect that typically develops after prolonged use of antipsychotic drugs, often longer than 2 years, and is not easily reversible or treated with anticholinergics.
A client has been admitted in septic shock. Her nursing care plan includes the diagnosis High Risk for Injury (related to clotting disorder). Based on this diagnosis, all the following are appropriate entries in the nursing care plan except:
- A. obtain an order for a stool softener.
- B. administer packed RBCs, if ordered.
- C. encourage the client to rinse her mouth with mouthwash and scrub her teeth with an oral sponge.
- D. dress venipuncture sites immediately to prevent infection.
Correct Answer: D
Rationale: Firm, direct pressure should be applied to venipuncture sites for 3-7 minutes before final dressing because of the clotting abnormality.