Nokea
The nurse is counseling a client regarding treatment of the client's newly diagnosed depression. The nurse emphasizes that full benefit from antidepressant therapy usually takes how long?
- A. 1 week
- B. 2 to 4 weeks
- C. 5 to 7 weeks
- D. 8 weeks
Correct Answer: B
Rationale: Antidepressants typically take 2 to 4 weeks to achieve full therapeutic effect, as they require time to adjust neurotransmitter levels. Other timeframes are too short or overly prolonged.
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You are caring for a multiple trauma client who has just arrived at the emergency room with a number of other external disaster victims. This client has multiple blast injuries and hypovolemic shock; it is anticipated that this unstable critically injured and unconscious client will have long term intravenous therapy, blood products and possibly hyperalimentation as well. Which type of venous access would you most likely anticipate for this client?
- A. A percutaneous, non tunneled subclavian catheter
- B. A peripheral intravenous catheter that is 20 gauge
- C. A multi lumen implanted tunneled and cuffed central venous catheter
- D. A peripherally inserted central venous catheter
Correct Answer: C
Rationale: A multi-lumen tunneled and cuffed central venous catheter is ideal for long-term therapy due to its durability and lower infection risk.
The nurse is caring for a client who has just returned to the nursing unit after an intravenous pyelogram (IVP). Which of the following nursing interventions is most appropriate at this time?
- A. Encourage a large fluid intake.
- B. Assess for return of bowel sounds.
- C. Assist with morning care.
- D. Administer a laxative as ordered.
Correct Answer: A
Rationale: Encouraging a large fluid intake post-IVP helps flush the contrast dye from the kidneys, reducing the risk of nephrotoxicity.
A client 6 weeks postpartum is asking the nurse about taking progesterone (Depo-Provera) for birth control. Which of the following should the nurse determine? Select all that apply.
- A. If the client has a sexually transmitted disease.
- B. How willing her husband is to have her take the drug.
- C. If the woman is experiencing postpartum depression.
- D. That the woman is not currently pregnant.
- E. If the woman is breast-feeding.
Correct Answer: C,D,E
Rationale: The nurse should assess for postpartum depression, pregnancy status, and breast-feeding, as these affect Depo-Provera's safety and efficacy. STDs and husband's willingness are not primary concerns.
You are the Assistant Director of Nursing in a multi ethnic and culturally diverse inner city acute care facility. You will be chairing a committee to develop a philosophy of nursing that addresses these facility characteristics and the characteristics of the clients. Which theoretical framework would you recommend that this committee should consider when addressing multi ethnicity and the culturally diverse nature of this facility for this philosophy?
- A. Jean Watson's
- B. Martha Rogers'
- C. Nagi's theory
- D. Madeleine Leininger's theory
Correct Answer: D
Rationale: Madeleine Leininger's theory of Transcultural Nursing focuses on providing culturally congruent care, making it the most appropriate framework for addressing the needs of a multi-ethnic and culturally diverse population.
The nurse is caring for a client with a history of peripheral arterial disease. Which of the following interventions should be included in the plan of care?
- A. Elevate the legs above heart level.
- B. Apply heating pads to the affected limbs.
- C. Encourage walking to tolerance.
- D. Restrict fluid intake.
Correct Answer: C
Rationale: Walking to tolerance improves collateral circulation in peripheral arterial disease.