Nokea
The nurse is providing teaching to a client starting monoamine oxidase inhibitor (MAOI) drug therapy. Which over-the-counter medications should the nurse instruct the client to avoid?
- A. Cold and allergy medications
- B. Antiulcer medications
- C. Multivitamins
- D. Laxatives
Correct Answer: A
Rationale: The nurse is correct to place cold and allergy medications on a clinical reference guide of over-the-counter medications to avoid. These preparations may have a drug-drug interaction. The client can use over-the-counter antiulcer medications, multivitamins, and laxatives per physician instruction.
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The nurse is caring for a client with a disturbance in thought process who is disoriented and aggressive. What nursing action may produce further agitation?
- A. Speaking in slow, brief sentences
- B. Presenting the reality of the situation
- C. Allowing the client freedom in a confined area
- D. Being present without speaking
Correct Answer: B
Rationale: When caring for a client with a disturbed thought process, presenting the reality of a situation may create conflict and confusion. Also, this can lead to a verbal exchange and escalation in agitation by the client. Actions by the nurse include attempts to decrease tension and anxiety such as speaking in slow, brief sentences so the client can comprehend instructions. Allow the client freedom when maintaining a safe environment. Being present to support and assist the client without speaking is less likely to produce agitation.
During the assessment of a client with mood disorder, the nurse observes that the client experiences hallucinations and delusions. What form of depressive disorders does the client experience?
- A. Reactive depression
- B. Mania
- C. Psychotic depression
- D. Seasonal affective disorder (SAD)
Correct Answer: C
Rationale: In psychotic depression, an extreme form of depressive disorder, some persons experience hallucinations and delusions. A reactive or secondary depression is a sad feeling that can be directly attributed to a situation or cause. Mania refers to the frenzied state of euphoria exhibited by persons during the manic phase of bipolar disorder. SAD is a mood disorder characterized by depressive feelings that develop during winter months and then disappear in the spring.
The nurse understands that clients who eat which of the following foods experience a food-drug interaction when taking phenelzine?
- A. Tangerines
- B. Fresh fish
- C. Yogurt
- D. Spinach and feta salad
Correct Answer: D
Rationale: The nurse understands that phenelzine is a monoamine oxidase inhibitor (MAOI). Clients who eat foods containing tyramine experience a food-drug interaction. When a MAOI is combined with foods containing tyramine (alcohol or aged cheese), a hypertensive crisis can occur. Feta cheese is an aged cheese. The other foods do not contain tyramine.
A client with bipolar disorder is having a disturbed thought process. What nursing intervention can help the client to be oriented and accurately perceive circumstances surrounding admission?
- A. Provide ample information.
- B. Support the client when in delusion.
- C. Reduce distracting stimuli.
- D. Offer a large-music activity.
Correct Answer: C
Rationale: The nurse should reduce distracting stimuli such as noise and stimulation. External stimuli potentiate client's internal activity. The nurse should not provide ample information at once, but rather should provide information in small amounts, using brief sentences. Brief discussion accommodates short attention span. The nurse should also present reality when the client is delusional and should not support the delusion of the client. Failing to present reality reinforces that the client's delusions are real. Exercise releases energy and reduces the potential for an angry outburst. It will not help a client with disturbed thought processes to be oriented.
The nurse is caring for a client who has selected transcranial magnetic stimulation to treat depression. For which side effect would the nurse provide preprocedural instructions?
- A. Headache
- B. Blurred vision
- C. Hearing loss
- D. Vertigo
Correct Answer: A
Rationale: The most frequent side effect following transcranial magnetic stimulation to treat depression is headache. Preprocedural instruction would include the most common symptom (headache) and interventions (pain management). Blurred vision, hearing loss, and vertigo are not common side effects.