A nurse is caring for a client who has major depression and a new prescription for citalopram.
Which of the following adverse effects is the priority for the nurse to report to the provider?

Weight loss.

Confusion.

Bruxism.

Insomnia.

Answer and Explanation

The Correct Answer is B

a. While weight changes can be concerning, they are not typically life-threatening and can occur as a common side effect of antidepressants, including citalopram. Monitoring is important, but it does not require immediate reporting.

b. This is the priority to report because confusion can indicate a serious reaction to the medication, such as serotonin syndrome, especially if it occurs in conjunction with other symptoms like agitation, hallucinations, or rapid heart rate. Confusion can also signal worsening mental status, which is critical for someone with major depression.

c. This refers to teeth grinding, which can occur with certain antidepressants. While it should be monitored and possibly addressed with interventions, it is generally not an immediate concern compared to confusion.

d. Sleep disturbances can be a side effect of citalopram and may need adjustment of treatment or recommendations for sleep hygiene, but they are not as urgent as confusion.

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Correct Answer is B

Explanation

The client has a negative sputum culture. This indicates that the client is adhering to the medication regimen because a negative sputum culture means that the client is no longer infectious and has cleared the tuberculosis bacteria from their lungs.

Choice A is wrong because testing negative for HIV does not indicate that the client is adhering to the medication regimen for tuberculosis. HIV testing is not related to tuberculosis treatment.

Choice C is wrong because having a positive purified protein derivative test does not indicate that the client is adhering to the medication regimen for tuberculosis.

A positive PPD test means that the client has been exposed to tuberculosis, but it does not indicate whether the client has an active or latent infection. Choice D is wrong because having liver function test results within the expected reference range does not indicate that the client is adhering to the medication regimen for tuberculosis.

Liver function tests are used to monitor for possible adverse effects of isoniazid and rifampin, which can cause hepatotoxicity, but they do not reflect the effectiveness of the treatment.

A. Administer epinephrine IM. B. Replace the infusion with 0.9% sodium chloride. C. Give diphenhydramine IM. D. Elevate the clients legs and feet.

Correct Answer is A

Explanation

Epinephrine (adrenaline) is the first-line treatment for anaphylaxis, a severe and potentially life-threatening allergic reaction. Epinephrine works by reducing the body’s allergic response and improving the breathing and circulation of the client. Epinephrine should be given as soon as possible after the onset of anaphylaxis symptoms, using an auto-injector device if available.

Choice B is wrong because replacing the infusion with 0.9% sodium chloride (normal saline) is not enough to treat anaphylaxis. Normal saline can help maintain the blood pressure and hydration of the client, but it does not reverse the allergic reaction or improve the breathing of the client. Normal saline can be given after epinephrine, but not before or instead of it.

Choice C is wrong because giving diphenhydramine IM is not enough to treat anaphylaxis. Diphenhydramine is an antihistamine that can help relieve some of the symptoms of anaphylaxis, such as itching and hives, but it works too slowly and does not address the more serious effects of anaphylaxis on the breathing and circulation of the client. Diphenhydramine can be given after epinephrine, but not before or instead of it.

Choice D is wrong because elevating the client's legs and feet is not enough to treat anaphylaxis. Elevating the legs and feet can help increase the blood flow to the vital organs, but it does not reverse the allergic reaction or improve the breathing of the client. Elevating the legs and feet can be done after epinephrine, but not before or instead of it.

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A nurse is caring for a client who has major depression and a new prescription for citalopram. Which of the following adverse effects is the priority for the nurse to report to the provider?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has tuberculosis and is taking isoniazid and rifampin. Which of the following outcomes indicates that the client is adhering to the medication regimen?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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A nurse is caring for a client who has major depression and a new prescription for citalopram.
Which of the following adverse effects is the priority for the nurse to report to the provider?