Nokea
The nurse is caring for a middle-aged client prescribed a selective serotonin reuptake inhibitor (SSRI). Which side effect of medication therapy leads to the most common cause of noncompliance?
- A. Hypertension
- B. Dizziness
- C. Hallucinations
- D. Sexual dysfunction
Correct Answer: D
Rationale: When taking a selective serotonin reuptake inhibitor, the nurse must instruct on the most common side effect, which is sexual dysfunction. Unfortunately, sexual dysfunction (reduced desire for sex, erectile and ejaculatory dysfunction, and the inability to orgasm) is a frequent and undesirable side effect that leads to noncompliance in medication regimen. The other side effects are not associated with use of SSRIs.
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A nurse is caring for a client newly admitted to the emergency department. The nurse obtains the following vital signs: temperature, 101.6?°F; pulse rate, 92 beats/minute; respiratory rate, 28 breaths/minute; and blood pressure, 160/90 mmHg. The client appears disheveled and disoriented. Upon physical assessment, the nurse notes restlessness and muscle spasms with rigidity. Which documented finding in the health history is evaluated as a potential causative factor?
- A. Mixing antibiotics with psychotherapeutic medications
- B. Changing from one psychotherapeutic to another
- C. Initiating psychotherapeutic drug therapy
- D. Combining dairy products with psychotherapeutics
Correct Answer: B
Rationale: Serotonin syndrome is a potentially life-threatening condition that results from elevated levels of serotonin in the blood secondary to drug therapy. When reviewing the client's medication history and relating the symptoms assessed, the nurse relates the client's status with changing from one psychotherapeutic to another psychotherapeutic medication as a potential causative factor. There is no correlation from the client symptoms to combining antibiotic therapy with psychotherapeutics, initiating psychotherapeutics, or combining dairy products with psychotherapeutics.
What is an example of sub-acute symptoms that may be observed in the older adult who may be depressed?
- A. Weight gain
- B. Lack of energy
- C. Memory loss
- D. Increased sleep
Correct Answer: B
Rationale: The examples of sub-acute symptoms that may be observed in the older adult who may be depressed are loss of appetite, trouble sleeping, lack of energy, and weight loss.
The nurse is caring for a client diagnosed with seasonal affective disorder (SAD). When caring for the client, at which time of the year does the nurse limit nursing interventions due to an uplifting of mood?
- A. September/October
- B. February/March
- C. April/May
- D. December/January
Correct Answer: C
Rationale: Clients experience an uplifting of mood during the springtime in the months of April/May. During this time, daylight becomes longer. As the mood improves, fewer nursing interventions including phototherapy are needed. As days shorten in fall, the client's mood may begin to worsen until it reaches its lowest point in the dark winter months.
The nurse is caring for a client who is receiving valproic acid. What clinical manifestation should the nurse periodically monitor for?
- A. Hepatotoxicity
- B. Hypertensive crisis
- C. Orthostatic hypotension
- D. Hyper alertness
Correct Answer: A
Rationale: The nurse should closely monitor a client on valproic acid, Depakote or Depakene, for hepatotoxicity. Frequent liver function tests and serum ammonia concentrations may be ordered. When a monoamine oxidase inhibitor is mixed with foods containing tyramine, clients are likely to develop a potentially fatal hypertensive crisis, not when taking valproic acid. Risk for orthostatic hypotension from psychotropic drugs is increased in older adults because of decreased functioning of the blood pressure-regulating mechanism. Some clients administered valproic acid experience sedation and ataxia.
Which observation(s) is helpful in determining a client's mood? Select all that apply.
- A. Client appearance
- B. Body language
- C. Speech
- D. Energy level
- E. Work history
Correct Answer: A,B,C,D
Rationale: The nurse can gather observational data using the assessment skill of inspection. Client appearance that is disheveled indicates signs of personal neglect. Body language may indicate evidence of anxiety, anger, or depression. Pace of speaking and energy level indicates mania or depression. Work history can be helpful in determining information related to a client's ability to fit in socially but is not included in observational data.