With Complete Solutions
107.) A client receiving a tricyclic antidepressant arrives at the
mental health clinic. Which observation indicates that the client
is correctly following the medication plan?
1. Reports not going to work for this past week
2. Complains of not being able to "do anything" anymore
3. Arrives at the clinic neat and appropriate in appearance
4. Reports sleeping 12 hours per night and 3 to 4 hours during
the day Correct Answer 3. Arrives at the clinic neat and
appropriate in appearance
Rationale:
Depressed individuals will sleep for long periods, are not able to
go to work, and feel as if they cannot "do anything." Once they
have had some therapeutic effect from their medication, they
will report resolution of many of these complaints as well as
demonstrate an improvement in their appearance.
108.) A nurse is performing a follow-up teaching session with a
client discharged 1 month ago who is taking fluoxetine (Prozac).
What information would be important for the nurse to gather
regarding the adverse effects related to the medication?
1. Cardiovascular symptoms
,2. Gastrointestinal dysfunctions
3. Problems with mouth dryness
4. Problems with excessive sweating Correct Answer 2.
Gastrointestinal dysfunctions
Rationale:
The most common adverse effects related to fluoxetine include
central nervous system (CNS) and gastrointestinal (GI) system
dysfunction. This medication affects the GI system by causing
nausea and vomiting, cramping, and diarrhea. Options 1, 3, and
4 are not adverse effects of this medication.
109.) A client taking buspirone (BuSpar) for 1 month returns to
the clinic for a follow-up visit. Which of the following would
indicate medication effectiveness?
1. No rapid heartbeats or anxiety
2. No paranoid thought processes
3. No thought broadcasting or delusions
4. No reports of alcohol withdrawal symptoms Correct Answer
1. No rapid heartbeats or anxiety
Rationale:
Buspirone hydrochloride is not recommended for the treatment
of drug or alcohol withdrawal, paranoid thought disorders, or
schizophrenia (thought broadcasting or delusions). Buspirone
,hydrochloride is most often indicated for the treatment of
anxiety and aggression.
110.) A client taking lithium carbonate (Lithobid) reports
vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and
tremors. The lithium level is checked as a part of the routine
follow-up and the level is 3.0 mEq/L. The nurse knows that this
level is:
1. Toxic
2. Normal
3. Slightly above normal
4. Excessively below normal Correct Answer 1. Toxic
Rationale:
The therapeutic serum level of lithium is 0.6 to 1.2 mEq/L. A
level of 3 mEq/L indicates toxicity.
111.) A client arrives at the health care clinic and tells the nurse
that he has been doubling his daily dosage of bupropion
hydrochloride (Wellbutrin) to help him get better faster. The
nurse understands that the client is now at risk for which of the
following?
1. Insomnia
2. Weight gain
3. Seizure activity
, 4. Orthostatic hypotension Correct Answer 3. Seizure activity
Rationale:
Bupropion does not cause significant orthostatic blood pressure
changes. Seizure activity is common in dosages greater than 450
mg daily. Bupropion frequently causes a drop in body weight.
Insomnia is a side effect, but seizure activity causes a greater
client risk.
112.) A hospitalized client is started on phenelzine sulfate
(Nardil) for the treatment of depression. The nurse instructs the
client to avoid consuming which foods while taking this
medication? Select all that apply.
1. Figs
2. Yogurt
3. Crackers
4. Aged cheese
5 Tossed salad
6. Oatmeal cookies Correct Answer 1. Figs
2. Yogurt
4. Aged cheese
Rationale:
Phenelzine sulfate (Nardil) is a monoamine oxidase
inhibitor(MAOI). The client should avoid taking in foods that
are high in tyramine. Use of these foods could trigger a