A nurse is caring for a client at a clinic.
Complete the following sentence by using the lists of options.
The client is at risk for developing
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}
Rationale for Correct Choices:
• Serotonin syndrome: The client’s symptoms recent SSRI dose increase indicate possible serotonin toxicity. Serotonin syndrome occurs when excessive serotonin accumulates in the body, typically following dose escalation or interaction between serotonergic medications. It is a medical emergency that can progress to seizures or death if not promptly identified and treated.
• Adverse effects of paroxetine: The increase in paroxetine dosage one week prior likely triggered excessive serotonergic activity. Paroxetine, an SSRI, elevates serotonin levels, and dose escalation can precipitate serotonin syndrome.
Rationale for Incorrect Choices:
• Generalized anxiety disorder: Although the client has a history of anxiety, the acute onset of fever, disorientation, and autonomic instability points to a physiological reaction rather than worsening anxiety. Anxiety may cause restlessness but does not produce hyperthermia or confusion.
• Neuroleptic malignant syndrome: This condition is associated with antipsychotic drugs, not SSRIs like paroxetine. While both syndromes can present with fever and altered mental status, the client’s medication profile and timing support serotonin toxicity instead.
• Feelings of hopelessness: Although ongoing hopelessness is part of the client’s depression, it does not explain the acute physical manifestations. Emotional symptoms may persist with depression, but fever and disorientation indicate a pharmacologic rather than psychological cause.
• Anxiety: Anxiety alone cannot account for the client’s fever, disorientation, or abdominal pain. These findings suggest a systemic reaction consistent with serotonin excess, not a purely psychological state.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
Rationale:
A. Bradypnea: Clients with end-stage kidney disease are more likely to experience Kussmaul respirations (rapid, deep breathing) as the body attempts to compensate for metabolic acidosis by exhaling excess carbon dioxide. Bradypnea is not a typical finding in renal failure and would indicate a different respiratory issue.
B. Oliguria: As kidney function declines, urine output decreases because the kidneys lose their ability to filter and excrete waste products effectively. Oliguria, or markedly reduced urine output, is a hallmark of end-stage renal disease and contributes to fluid overload.
C. Anemia: The kidneys normally produce erythropoietin, which stimulates red blood cell production. In end-stage kidney disease, decreased erythropoietin production leads to anemia, resulting in fatigue, pallor, and decreased oxygen-carrying capacity.
D. Hypotension: Clients with kidney failure often experience hypertension rather than hypotension due to fluid retention and activation of the renin-angiotensin-aldosterone system. Hypotension would be more characteristic of acute volume depletion, not chronic renal failure.
E. Edema: Impaired kidney function causes sodium and water retention, leading to fluid accumulation in tissues. Peripheral and periorbital edema are common manifestations of end-stage kidney disease due to reduced excretion of excess fluid.
Correct Answer is C
Explanation
Rationale:
A. Discharge the client to hospice care: While hospice care may be appropriate for clients with end-stage disease, discharge to hospice is not the immediate nursing action in response to a DNR request. The priority is to acknowledge the client’s wishes and ensure the DNR order is properly documented.
B. Place a sign with "Do Not Resuscitate" outside the client's room: A visible sign is used after a formal DNR order is entered into the medical record. Placing a sign prematurely without provider authorization or documentation does not legally protect the client’s wishes.
C. Explain to the client they can change their mind at any time: It is important to respect client autonomy while clarifying that a DNR order is revocable. Providing this information supports informed decision-making and ensures the client understands that their preferences can be updated at any time.
D. Obtain consent from the family for the change to the plan of care: The client’s decision regarding resuscitation takes priority if they have decision-making capacity. Family consent is not required for a competent adult to make a DNR decision.
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