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The nurse is caring for a client with a diagnosis of major depressive disorder who has been prescribed fluoxetine (Prozac). What is the most important teaching point?
- A. Take the medication with or without food.
- B. Report any increase in suicidal thoughts.
- C. Avoid foods high in tyramine.
- D. Expect improvement within 24 hours.
Correct Answer: B
Rationale: The correct teaching point is to instruct the client to report any increase in suicidal thoughts. This is crucial because SSRIs like fluoxetine can initially increase suicidal ideation, especially at the beginning of treatment. Choice A is corrected to emphasize that fluoxetine can be taken with or without food. Choice C is unrelated as it pertains more to MAOIs than SSRIs like fluoxetine. Choice D is inaccurate as antidepressants like fluoxetine may take weeks to show significant improvement in symptoms, not within 24 hours.
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The client with a diagnosis of hypertension is being taught about lifestyle changes. Which recommendation is most important to include?
- A. Increase sodium intake.
- B. Engage in regular physical activity.
- C. Avoid foods high in fat.
- D. Limit fluid intake to 1 liter per day.
Correct Answer: B
Rationale: Engaging in regular physical activity is crucial for individuals with hypertension as it helps lower blood pressure and improve cardiovascular health. Physical activity is known to have a significant impact on reducing hypertension and overall cardiovascular risk. Choice A, increasing sodium intake, is incorrect as reducing sodium is typically recommended for hypertension to help lower blood pressure. Choice C, avoiding foods high in fat, is beneficial for overall health but not the most crucial recommendation for hypertension management. Choice D, limiting fluid intake to 1 liter per day, is not a standard recommendation for hypertension unless advised by a healthcare provider for specific cases. Therefore, the most important recommendation for the client with hypertension is to engage in regular physical activity.
What intervention should the nurse implement for a client experiencing an anxiety attack?
- A. Teach deep breathing exercises
- B. Provide a quiet environment
- C. Administer anxiolytic medication as prescribed
- D. Engage the client in conversation
Correct Answer: C
Rationale: Administering prescribed anxiolytic medication is the most appropriate intervention for a client experiencing an anxiety attack. Anxiolytic medications can provide rapid relief from severe anxiety symptoms. Teaching deep breathing exercises (choice A) can be helpful for managing mild anxiety but may not be sufficient during an acute anxiety attack. Providing a quiet environment (choice B) is beneficial to reduce stimuli, but it may not address the immediate distress of an ongoing anxiety attack. Engaging the client in conversation (choice D) is generally not recommended during an anxiety attack as it can potentially exacerbate the symptoms by increasing stimulation.
A client is prescribed warfarin for the prevention of thromboembolism. What dietary instruction should the nurse provide?
- A. Increase intake of green leafy vegetables
- B. Maintain a consistent intake of vitamin K-rich foods
- C. Avoid all foods containing vitamin K
- D. Consume a high-protein diet
Correct Answer: B
Rationale: The correct answer is B. Maintaining a consistent intake of vitamin K-rich foods is important for patients taking warfarin as it helps keep the effects of the medication stable. Choice A is incorrect because while green leafy vegetables are high in vitamin K, they should not be avoided completely but rather consumed consistently. Choice C is also incorrect as avoiding all foods containing vitamin K can lead to fluctuations in warfarin's effectiveness. Choice D is incorrect as a high-protein diet is not specifically recommended for patients taking warfarin.
A client with a history of peptic ulcer disease (PUD) is prescribed omeprazole (Prilosec). What is the primary action of this medication?
- A. Neutralizes stomach acid
- B. Reduces gastric acid production
- C. Forms a protective barrier over ulcers
- D. Increases gastric mucus production
Correct Answer: B
Rationale: The correct answer is B: Reduces gastric acid production. Omeprazole is a proton pump inhibitor that works by reducing gastric acid production, thereby helping to heal ulcers. While neutralizing stomach acid is associated with antacids, forming a protective barrier over ulcers is more characteristic of medications like sucralfate. The action described in choice D, increasing gastric mucus production, is not the primary mechanism of action of omeprazole in treating peptic ulcer disease.
A client with a diagnosis of chronic kidney disease (CKD) is receiving epoetin alfa (Epogen). What is the primary goal of this medication?
- A. To reduce the risk of bleeding.
- B. To lower blood pressure.
- C. To stimulate red blood cell production.
- D. To increase appetite.
Correct Answer: C
Rationale: The correct answer is C: 'To stimulate red blood cell production.' Epoetin alfa, such as Epogen, is used to treat anemia by stimulating red blood cell production in clients with chronic kidney disease. This medication helps increase hemoglobin levels and reduce the need for blood transfusions. Option A, 'To reduce the risk of bleeding,' is incorrect as epoetin alfa does not directly impact bleeding risk. Option B, 'To lower blood pressure,' is incorrect as epoetin alfa is not indicated for blood pressure management. Option D, 'To increase appetite,' is also incorrect as the primary goal of epoetin alfa is related to improving anemia by boosting red blood cell production.