A nurse in an acute mental-health facility is caring for an adolescent who is exhibiting destructive behavior. Which of the following actions should the nurse take after applying physical restraints to the client?

The correct answer is choice D. Decreased hemoglobin.

Choice A rationale:

Cigarette smoking typically causes an increase in blood pressure due to the nicotine’s stimulating effects on the cardiovascular system, not a decrease.

Choice B rationale:

Smoking is more likely to cause tachycardia (increased heart rate) rather than bradycardia (decreased heart rate) because nicotine stimulates the release of adrenaline.

Choice C rationale:

Somnolence (drowsiness) is not a common adverse effect of cigarette smoking. Smoking usually has a stimulating effect due to nicotine.

Choice D rationale:

Decreased hemoglobin can occur as a result of smoking because it can lead to chronic obstructive pulmonary disease (COPD) and other respiratory issues, which can impair oxygen transport in the blood. Additionally, smoking can cause carbon monoxide to bind with hemoglobin, reducing its oxygen-carrying capacity.

Choice A reason

Increased food intake does not show medication is effective: Increased food intake is not a specific indication of donepezil's effectiveness. While some clients with dementia may have improved appetite due to reduced agitation or confusion, it is not directly related to the medication's therapeutic effect.

Choice B reason:

Can perform ADLs independently is inappropriate: The ability to perform activities of daily living (ADLs) independently can be a positive outcome in clients with dementia. However, it may not be solely attributed to donepezil, as ADLs can be influenced by various factors, including the client's overall condition and support received.

Choice C reason:

Improved short-term memory is correct. One of the primary goals of using donepezil is to improve memory and slow the decline in cognitive abilities associated with dementia. Therefore, if a client shows improvement in short-term memory, it suggests that the medication is having a positive effect in preserving cognitive function.

Choice D reason

Enhanced mood does not show the medicine is effective: Donepezil is primarily aimed at improving cognitive function and memory, and its effects on mood may be limited. While some clients may experience mood improvements due to reduced frustration or confusion from memory loss, it is not the primary indicator of the medication's effectiveness