unit 7 NCLEX

Fluoxetine hydrochloride (Prozac) is prescribed for a client being treated for depression, and the nurse reinforces instructions to the client regarding the medication. Which statement by the client would indicate that the client understands this medication therapy?

"It takes approximately 2 to 4 weeks before improvement is noted."

A client says to the nurse, "I'm going to die, and I wish my family would stop hoping for a 'cure'! I get so angry when they carry on like this! After all, I'm the one who's dying." Which therapeutic response should the nurse make to the client?

"You're feeling angry that your family continues to hope for you to be 'cured'?"

Laboratory work is prescribed for a client who has been experiencing delusions. When the laboratory technician approaches the client to obtain a specimen of the client's blood, the client begins to shout, "You're all vampires. Let me out of here!" The nurse present at the time should respond by stating which?

''Are you fearful and think that others may want to hurt you?"

A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. At lunchtime, a tray is delivered to the client. Which food item on the tray should the nurse remove?

--Yogurt

A client receiving lithium carbonate (Lithobid) complains of loose, watery stools and difficulty walking. The nurse should expect the serum lithium level to be which?

1.7 mEq/L

The nurse is preparing a client for the termination phase of the nurse-client relationship. Which task should the nurse appropriately plan for this phase?

Assist in making appropriate referrals.

Diphenhydramine hydrochloride (Benadryl) is used in the treatment of allergic rhinitis for a hospitalized client with a chronic psychotic disorder. The client asks the nurse why the medication is being discontinued before hospital discharge. How should the nurse respond correctly to this question?

Addictive properties are enhanced in the presence of psychotropic medications.

A client who is on lithium carbonate (Lithobid) will be discharged at the end of the week. In reinforcing a discharge teaching plan, the nurse should include which instructions?

Check with the psychiatrist before using any over-the-counter (OTC) medications or prescription medications.

When teaching a client who is being started on imipramine hydrochloride (Tofranil), when should the nurse tell the client that the medication should have the desired effects?

Desired effects do not occur for 2 to 3 weeks of administration.

A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. The nurse reinforces instructions to the client and tells the client to avoid consuming which foods while taking this medication? Select all that apply.

Figs 2. Yogurt 4. Aged cheese

A client admitted to the hospital gives the nurse a bottle of clomipramine (Anafranil). The nurse notes that the medication has not been taken by the client in 2 months. Which behavior observed in the client would validate noncompliance with this medication?

Frequent hand washing with hot, soapy water

A client is being treated for depression with amitriptyline hydrochloride. During the initial phases of treatment, which is the most important nursing intervention?

Getting baseline postural blood pressures before administering the medication and each time the medication is administered

The nurse is monitoring a client taking an antipsychotic medication for signs of neuroleptic malignant syndrome (NMS). The nurse should expect to note which sign/symptom if NMS occurred?

Hyperpyrexia

The nurse is assigned to care for a client admitted to the hospital after sustaining an injury from a house fire. The client attempted to save a neighbor involved in the fire, but despite the client's efforts, the neighbor died. Which action should the nurse take to enable the client to work through the meaning of the crisis?

Inquiring about the client's feelings that may affect coping

A client with a history of simple partial seizures is taking clorazepate (Tranxene). The client asks the nurse whether there is a risk of addiction. The nurse's response is based on which understanding of clorazepate?

Leads to physical and psychological dependence with prolonged, high-dose therapy

A client taking buspirone (BuSpar) for 1 month returns to the clinic for a follow-up visit. Which should indicate medication effectiveness?

No rapid heartbeats or anxiety

A client taking buspirone hydrochloride (BuSpar) for 1 month is scheduled for a follow-up appointment. The nurse gathers data from the client and interprets that the medication is effective if the client reports an absence of which symptom?

Palpitations and anxiety

A client is taking a monoamine oxidase (MAO) inhibitor. The nurse plans care, knowing which information?

Symptomatology of drug toxicity includes headache, hypertension, and nausea and vomiting.

A client is admitted to the psychiatric nursing unit. When collecting data from the client, the nurse notes that the client was admitted on an involuntary status. Based on this type of admission, the nurse expects which?

The client presents a harm to self.

A client in the mental health unit is administered haloperidol (Haldol). What should the nurse check to determine medication effectiveness?

The client's orientation and delusional status

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 which?

Toxic

The nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the client should the nurse specifically review to monitor for an adverse effect associated with the use of this medication?

White blood cell count

A tricyclic antidepressant is administered to a client daily. The nurse plans to alleviate the common side effects of the medication and includes which in the plan of care?

Offer hard candy or gum periodically.