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A nurse is caring for a client in the outpatient health clinic.

Exhibits

For each potential nursing intervention, click to specify if the intervention is indicated or not indicated.

A.

Instruct client to avoid foods that have been fermented or aged.

B.

Encourage client to sleep until later in the morning.

C.

Advise client to notify provider if pregnant.

D.

Encourage high-calorie finger foods.

E.

Advise client to rise slowly from sitting position.

F.

Encourage naps during the day when client is tired.

G.

Encourage a regular sleep-wake schedule.

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"},"G":{"answers":"A"}}

Rationale:

  • Instruct client to avoid foods that have been fermented or aged: This dietary restriction applies to monoamine oxidase inhibitors (MAOIs), not trazodone, which is a serotonin antagonist and reuptake inhibitor (SARI).
  • Encourage client to sleep until later in the morning: Oversleeping can disrupt circadian rhythms and worsen fatigue. A consistent, balanced sleep schedule is more therapeutic.
  • Advise client to notify provider if pregnant: Trazodone is a category C medication and should only be used in pregnancy if the benefits outweigh the risks. The provider must be informed if the client is or may become pregnant.
  • Encourage high-calorie finger foods: The client has experienced weight loss and decreased appetite. Nutrient-dense, easy-to-eat foods can support caloric intake without requiring full meals.
  • Advise client to rise slowly from sitting position: Trazodone can cause orthostatic hypotension. Educating the client to change positions slowly helps prevent dizziness and potential falls.
  • Encourage naps during the day when client is tired: Daytime napping can interfere with nighttime sleep and may reduce trazodone’s effectiveness in establishing a healthy sleep pattern.
  • Encourage a regular sleep-wake schedule: Trazodone is often prescribed for sleep difficulties. A consistent routine supports sleep hygiene and enhances the medication’s effectiveness.


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Related Questions

Correct Answer is C

Explanation

Rationale:

A. Take mineral oil at bedtime: Mineral oil is not recommended for long-term use because it can interfere with absorption of fat-soluble vitamins and may lead to aspiration pneumonia, especially in older adults. Safer stool softeners or laxatives should be used for opioid-induced constipation.

B. Decrease insoluble fiber intake: Insoluble fiber, such as wheat bran, helps bulk the stool and promote bowel movements. Reducing fiber intake can worsen constipation rather than relieve it, especially in clients taking opioids.

C. Increase exercise activity: Regular physical activity stimulates peristalsis and helps prevent constipation. Movement is a key non-pharmacologic strategy to counteract the slowed gastrointestinal motility caused by opioids.

D. Drink 1.5 L of fluids each day: Although hydration is important, adults typically require around 2 to 3 liters of fluid daily unless contraindicated. Limiting intake to 1.5 L may be insufficient to support normal bowel function and soften stool.

Correct Answer is D

Explanation

Rationale:

A. A client who has decreased interleukin-6 levels: Interleukin-6 is a pro-inflammatory cytokine that may be elevated in depression, but its decrease is not an indicator for antidepressant use. It’s not routinely used to determine the need for antidepressant therapy in clinical practice.

B. A client who has decreased urine cortisol levels: Depression is more commonly associated with increased cortisol levels due to stress responses. Low cortisol may be seen in conditions like Addison's disease but does not typically guide antidepressant use.

C. A client who has decreased C-reactive protein levels: CRP is a nonspecific inflammatory marker. While elevated CRP has been observed in some individuals with depression, a decreased CRP level would not indicate the need for antidepressant therapy.

D. A client who has decreased serotonin levels: Low serotonin levels are closely linked to depression pathophysiology. Many antidepressants, such as SSRIs, target serotonin levels to relieve depressive symptoms, making this the most relevant indicator for antidepressant therapy.

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