A nurse is assessing a client who has depression and takes phenelzine. The client reports eating pepperoni pizza while out on a pass during lunchtime. Which of the following assessments should the nurse perform?

Oxygen saturation

Blood pressure

Pupil response

Bowel sounds

Answer and Explanation

The Correct Answer is B

Phenelzine is a monoamine oxidase inhibitor (MAOI) that can cause a hypertensive crisis if taken with foods that contain tyramine, such as pepperoni pizza. The nurse should assess the client's blood pressure to monitor for signs of hypertension, such as headache, chest pain, or blurred vision.

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Correct Answer is ["A","D","E"]

Explanation

Positive symptoms of schizophrenia are those that add something to the normal experience, such as hallucinations, delusions, disorganized speech, and abnormal motor behavior. Flight of ideas is a type of disorganized speech that involves rapid switching from one topic to another. Delusions of grandeur are false beliefs of having superior power or status. Auditory hallucinations are hearing voices or sounds that are not real. Negative symptoms of schizophrenia are those that take something away from the normal experience, such as decreased motivation, impaired memory, flat affect, and social withdrawal.

A. "Ask a family member to check the locks for you at night." B. "Focus on abdominal breathing whenever you go to check the locks." C. "Keep a journal of how often you check the locks each night." D. "Snap a rubber band on your wrist when you think about checking the locks."

Correct Answer is D

Explanation

Thought stopping technique is a cognitive-behavioral intervention that aims to interrupt and replace unwanted thoughts with more adaptive ones. Snapping a rubber band on the wrist is a form of aversive conditioning that creates a negative association with the obsessive thought and reduces its frequency and intensity.

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A nurse is assessing a client who has depression and takes phenelzine. The client reports eating pepperoni pizza while out on a pass during lunchtime. Which of the following assessments should the nurse perform?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has schizophrenia. Which of the following findings should the nurse document as positive symptoms of schizophrenia? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

A nurse is providing behavioral therapy for a client who has obsessive-compulsive disorder. The client repeatedly checks that the doors are locked at night. Which of the following instructions should the nurse give the client when using thought stopping technique?

Correct Answer is D

Explanation

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