Nursing Elites

1. A client with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?

• A. It can take several weeks before you feel like the medication is helping.
• B. Take the medication just before bedtime to promote sleep.
• C. You should take the medication when needed for obsessive urges.
• D. Monitor for weight gain while taking this medication.

Correct answer: A

Rationale: The correct instruction for the nurse to include when teaching a client with OCD who has a new prescription for Paroxetine is that it can take several weeks before the client feels like the medication is helping. Paroxetine, like other selective serotonin reuptake inhibitors (SSRIs), can take 1 to 4 weeks before the client reaches the full therapeutic benefit. Therefore, it is important to inform the client about this delay in onset of action to manage their expectations and promote adherence to the treatment plan. Choices B, C, and D are incorrect because taking Paroxetine before bedtime is not necessary, it should be taken consistently at the same time each day; Paroxetine is usually taken regularly, not as needed; and while monitoring weight is important, it is not a specific instruction related to the onset of action for Paroxetine.

2. A client is receiving warfarin therapy. Which of the following findings should the nurse identify as an adverse effect of warfarin?

• A. Nausea
• B. Epistaxis
• C. Diarrhea
• D. Dyspepsia

Correct answer: B

Rationale: Epistaxis, or nosebleeds, can be an indication of excessive anticoagulation while on warfarin therapy. Warfarin is a blood thinner that helps prevent blood clots. Epistaxis can occur as a result of the blood-thinning effects of warfarin, leading to increased bleeding tendencies, including nosebleeds. Nausea, diarrhea, and dyspepsia are not typically associated with warfarin therapy; therefore, they are not the adverse effects the nurse should identify in a client receiving warfarin.

3. Which of the following is the antidote for benzodiazepine toxicity?

• A. Flumazenil
• B. Methylene blue
• C. Deferoxamine
• D. Alkalinize urine

Correct answer: A

Rationale: Flumazenil is the specific antidote for benzodiazepine toxicity. It acts as a competitive antagonist at the benzodiazepine binding site on the GABA receptor, reversing the sedative effects of benzodiazepines. Administration of flumazenil is indicated in cases of benzodiazepine overdose or toxicity to rapidly reverse the central nervous system depression caused by these drugs. It is important to note that flumazenil should be used cautiously in patients with a history of seizures or those who are physically dependent on benzodiazepines, as it can precipitate withdrawal symptoms or seizures.

4. What is the expected outcome of Valproate therapy?

• A. Decreased fever
• B. Decreased sense of anxiety
• C. Decreased blood pressure
• D. Decreased seizure activity

Correct answer: D

Rationale: The correct answer is D: Decreased seizure activity. Valproate is commonly used in the treatment of epilepsy to help control and reduce seizure frequency. Choices A, B, and C are incorrect because Valproate is not primarily used to treat fever, anxiety, or blood pressure issues.

5. A client has been prescribed Aspirin for prevention of cardiovascular disease. Which of the following findings indicates the medication is effective?

• A. The client has a decrease in troponin levels.
• B. The client has a regular heart rhythm.
• C. The client experiences a decrease in episodes of angina.
• D. The client's blood pressure remains stable.

Correct answer: C

Rationale: The correct answer is C. A decrease in episodes of angina indicates that Aspirin is effectively preventing the formation of clots that could lead to cardiovascular events. Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle, usually due to coronary artery disease. Aspirin works by inhibiting platelet aggregation, thereby reducing the risk of clot formation in the arteries. Improvement in angina symptoms suggests that the medication is successfully preventing clot-related complications in the cardiovascular system. Monitoring and recognizing a decrease in angina episodes can be a valuable indicator of the medication's efficacy in preventing cardiovascular events. Choices A, B, and D are incorrect because a decrease in troponin levels, a regular heart rhythm, or stable blood pressure, while important parameters, do not directly reflect the effectiveness of Aspirin in preventing cardiovascular events through antiplatelet action.

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