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Which of the following instructions are appropriate to include in the teaching plan of a client who is just beginning treatment with imipramine hydrochloride (Tofranil)? Select all that apply.
- A. Avoid tyramine-rich foods such as aged cheese and pickled foods.
- B. Take short naps during the day.
- C. Rise from the chair or bed slowly.
- D. Expect to wait about 3 weeks before feeling better.
- E. Refrain from all sexual activity for 1 month after starting the medication.
- F. Use a good sunscreen when outdoors.
Correct Answer: A,C,D
Rationale: Avoiding tyramine prevents hypertensive crisis, slow rising reduces orthostatic hypotension, and delayed effects set realistic expectations.
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Which finding noted by the nurse during the postoperative assessment is most indicative of the client's alcoholism?
- A. Blood pressure is lower than normal.
- B. Pain is unrelieved with usual dosages of analgesics.
- C. The client asks for a beer.
- D. Pulse rates are slow, weak, and irregular.
Correct Answer: B
Rationale: Alcoholism can lead to tolerance, requiring higher analgesic doses for pain relief due to altered liver metabolism and receptor sensitivity.
Which form of instruction is most beneficial when preparing the anxious client?
- A. Provide detailed explanations.
- B. Use short, simple sentences.
- C. Draw elaborate diagrams.
- D. Show a teaching DVD.
Correct Answer: B
Rationale: Short, simple sentences are easier for an anxious client to process, reducing cognitive overload and improving comprehension.
The nurse is caring for the client who was violently raped 3 months ago and has a diagnosis of rape-trauma syndrome. Which assessment findings associated with rape-trauma syndrome should the nurse anticipate? Select all that apply.
- A. Anorexia
- B. Nightmares
- C. Hypertension
- D. Fears and phobias
- E. Sexual promiscuity
Correct Answer: A ,B, D
Rationale: Rape-trauma syndrome symptoms include physiological symptoms such as loss of appetite (A) nightmares of the attack occurring again (B) and fears and phobias (D) due to feelings of vulnerability. Hypertension (C) is not a recognized symptom and fear of sexual encounters not promiscuity (E) is typical.
The nurse is preparing to document the client’s violent episode. Which statements should be included specifically about the violent episode? Select all that apply.
- A. Client’s wife called during the escalation cycle.
- B. Client refused to voluntarily enter into seclusion.
- C. Client stated “All of you are just evil people.”
- D. Attempts to identify the cause of client’s agitation failed.
- E. Five staff members responded to “Emergency Code.”
- F. Client asked to leave seclusion room after 30 minutes.
Correct Answer: B ,C, D, F
Rationale: Documentation includes refusal of seclusion (B) client statements (C) failed interventions (D) and reintegration (F). Wife’s call (A) and staff numbers (E) are irrelevant.
What nursing approach is most beneficial for helping the nursing assistant at this time?
- A. Sending the nursing assistant home for the rest of the shift
- B. Terminating the nursing assistant from this type of work
- C. Allowing the nursing assistant to express feelings
- D. Asking the nursing assistant to help with postmortem care
Correct Answer: C
Rationale: Allowing expression of feelings helps the assistant process grief, supporting emotional well-being after a distressing event.