Nokea
The physician has prescribed imipramine (ToFranil) for a client with depression. The nurse should continue to monitor the client's affect because the maximal effects of tricyclic antidepressant medication do not occur for:
- A. 48-72 hours
- B. 5-7 days
- C. 2-4 weeks
- D. 3-6 months
Correct Answer: C
Rationale: Tricyclic antidepressants like imipramine take 2-4 weeks to reach maximal therapeutic effect, requiring ongoing monitoring of the client's mood.
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A 6-month-old client is placed on strict bed rest following a hernia repair. Which toy is best suited to the client?
- A. Colorful crib mobile
- B. Hand-held electronic games
- C. Cars in a plastic container
- D. 30-piece jigsaw puzzle
Correct Answer: A
Rationale: A colorful crib mobile is age-appropriate and safe for a 6-month-old on bed rest, providing visual stimulation.
A 60-year-old diabetic is taking glyburide (Diabeta) 1.25 mg daily to treat Type II diabetes mellitus. Which statement indicates the need for further teaching?
- A. I will keep candy with me just in case my blood sugar drops.
- B. I need to stay out of the sun as much as possible.
- C. I often skip dinner because I don't feel hungry.
- D. I always wear my medical identification.
Correct Answer: C
Rationale: Skipping meals while on glyburide increases hypoglycemia risk, indicating a need for further teaching.
A client has recently lost her best friend to cancer. The client tells the nurse, 'I'm very sad about the loss of my friend.' Which of the following responses by the nurse is the most appropriate?
- A. I lost my best friend two years ago, but I feel better now.
- B. It's important for you to keep busy.
- C. Why do you feel this way?
- D. It's normal to feel loss. Tell me about your friend.
Correct Answer: D
Rationale: This response validates the client’s grief and encourages her to share, promoting therapeutic communication and emotional support.
The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a diagnosis of a ruptured ectopic pregnancy?
- A. Painless vaginal bleeding
- B. Abdominal cramping
- C. Throbbing pain in the upper quadrant
- D. Sudden, stabbing pain in the lower quadrant
Correct Answer: D
Rationale: A ruptured ectopic pregnancy typically causes sudden, severe lower quadrant pain due to internal bleeding.
A client who is to undergo electroconvulsive therapy for severe depression is quite anxious about the treatment and asks the nurse what to expect after treatment. Which of the following information should the nurse include? Select all that apply.
- A. The client will experience confusion for a short time.
- B. Headache and muscle soreness are common.
- C. Some degree of memory loss, usually transient, may occur.
- D. Possible urinary incontinence may occur for 12 hours.
- E. The client may experience hallucinations for 2 to 3 weeks.
Correct Answer: A,B,C
Rationale: ECT causes short-term confusion (A), headache/muscle soreness (B), and transient memory loss (C). Incontinence (D) and prolonged hallucinations (E) are not typical.