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A nurse is assisting in the care of a client in an outpatient mental health clinic.

Click to highlight the findings that indicate the client is experiencing adverse effects of the medication. To deselect a finding, click on the finding again.

Nurses' Notes

Today:

Client states, "I'm feeling much better." They report less fatigue, even though they have difficulty sleeping. Client reports they are not sad anymore but are experiencing more frequent headaches. Client continues to deny any suicidal ideation.

Vital Signs

Today:

Blood pressure 169/91 mm Hg

Heart rate 78/min

Respiratory rate 18/min

even though they have difficulty sleeping

experiencing more frequent headaches

Blood pressure 169/91 mm Hg

Client continues to deny any suicidal ideation

Heart rate 78/min

Respiratory rate 18/min

Answer and Explanation

The Correct Answer is ["A","B","C"]

Frequent headaches: Phenelzine, an MAOI, can cause hypertensive crisis, with one of the earliest signs being persistent or worsening headaches. Frequent headaches must be treated as a possible warning of dangerously elevated blood pressure and require immediate provider notification.
Elevated blood pressure (169/91 mm Hg): The significant rise in the client's blood pressure compared to baseline indicates new-onset hypertension. This is a serious adverse effect associated with MAOIs and signals the potential development of a hypertensive crisis, which must be urgently addressed.
Difficulty sleeping: Difficulty sleeping or insomnia is a common side effect of phenelzine and other antidepressants. Although not life-threatening, insomnia can impair recovery if untreated and should be documented and discussed with the provider to adjust management if needed.
Feeling much better: Improvement in mood and reduced fatigue are intended therapeutic outcomes of phenelzine treatment. These findings are positive signs and do not indicate an adverse reaction that needs intervention.
Heart rate 78/min and respiratory rate 18/min: Both values are within normal ranges and do not suggest immediate concerns related to cardiovascular or respiratory function. They should continue to be monitored but do not require urgent action.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. "I should limit my intake of leafy green vegetables.": Limiting leafy green vegetables is associated with warfarin therapy because of their vitamin K content. It is not relevant to metoprolol, which primarily affects the cardiovascular system and does not interact significantly with dietary vitamin K.

B. "I may experience loss of taste.": Loss of taste is not a common side effect of metoprolol. Metoprolol is more associated with cardiovascular side effects such as bradycardia, hypotension, and dizziness rather than alterations in taste perception.

C. "I need to be careful when standing up from bed.": This is correct because metoprolol can cause orthostatic hypotension, leading to dizziness or lightheadedness upon standing. Clients are advised to rise slowly from a lying or seated position to reduce the risk of falls and fainting.

D. "I should expect some weight loss.": Metoprolol is more commonly associated with weight gain or no significant weight change rather than weight loss. Clients taking beta-blockers sometimes experience fluid retention or a slowed metabolism, leading to modest weight gain.

A. Epinephrine relaxes the bronchioles and counteracts the effect of histamine B. Epinephrine should be given along with a beta blocker. C. Epinephrine should be administered intranasally D. Epinephrine causes a decrease in blood pressure

Correct Answer is A

Explanation

A. Epinephrine relaxes the bronchioles and counteracts the effect of histamine: Epinephrine is the first-line treatment for anaphylaxis because it rapidly relaxes bronchial smooth muscles, reducing airway constriction, and counteracts histamine's effects, which include vasodilation, edema, and hypotension. This helps restore breathing and circulation.

B. Epinephrine should be given along with a beta blocker: Administering epinephrine with a beta blocker is dangerous because beta blockers can reduce the effectiveness of epinephrine and may worsen bronchospasm. Beta blockers are not recommended during acute management of anaphylaxis.

C. Epinephrine should be administered intranasally: Epinephrine is typically administered intramuscularly (IM), usually into the thigh, during anaphylactic emergencies for rapid absorption. Intranasal administration is not effective for treating life-threatening systemic allergic reactions.

D. Epinephrine causes a decrease in blood pressure: Epinephrine actually increases blood pressure by causing vasoconstriction. This counters the dangerous hypotension that occurs during anaphylaxis, helping to stabilize cardiovascular function quickly.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about the side effects of metoprolol. Which of the following client statements indicates an understanding of the teaching?

Correct Answer is C

Explanation

A nurse is reinforcing teaching about receiving epinephrine as an emergency intervention for anaphylaxis. Which of the following information should the nurse reinforce with the client?

Correct Answer is A

Explanation

A nurse is receiving a telephone prescription from a client's provider. Which of the following actions should the nurse take? (Select all that apply)

Parents of an adolescent client experiencing a relapse of leukemia do not want the client to know about the relapse. Which of the following ethical principles must a nurse consider when the client asks about their medical status?

A nurse is collecting data from a child who is 1 hr postoperative following a tonsillectomy. Which of the following findings is the nurse's priority?

A male nurse is assigned to care for an older adult female client. The client tells the nurse that she wants a female nurse to care for her. Which of the following statements should the nurse make?

A nurse is collecting data from a client who is receiving hydromorphone for pain management. For which of the following findings should the nurse notify the provider?

A nurse is preparing to transfer a client who is non-weight bearing from the bed to a chair with the aid of an assistive personnel. The client is cooperative and has upper body strength. Which of the following assistive devices should the nurse use when transferring the client?

A nurse is collecting data from a client who is at 35 weeks of gestation. Which of the following findings should the nurse report to the provider?