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 C

Explanation

Taking a high-ceiling diuretic predisposes this client to developing digoxin toxicity because it can cause hypokalemia (low blood potassium level), which increases the sensitivity of the heart to digoxin. Digoxin is a medicine that is used to treat heart failure or arrhythmias (abnormal heart rhythms) by increasing cardiac contractility and controlling the heart rate. Digoxin toxicity happens when there is too much digoxin in the body and it becomes harmful, causing symptoms such as nausea, vomiting, headache, confusion, vision disturbance, and irregular heartbeat.

Choice A is wrong because taking an HMG CoA reductase inhibitor (also called a statin) does not increase the risk of digoxin toxicity.

Statins are lipid-lowering medications used to prevent coronary heart disease by blocking an enzyme involved in cholesterol synthesis.

Statins do not affect the blood potassium level or the sensitivity of the heart to digoxin.

Choice B is wrong because having a 10-year history of COPD (chronic obstructive pulmonary disease) does not increase the risk of digoxin toxicity. COPD is a lung condition that causes breathing difficulties and chronic inflammation.

COPD does not affect the blood potassium level or the sensitivity of the heart to digoxin.

Choice D is wrong because having a prolapsed mitral valve does not increase the risk of digoxin toxicity.

A prolapsed mitral valve is a condition where the valve between the left atrium and left ventricle of the heart does not close properly, allowing some blood to leak back into the atrium.

A prolapsed mitral valve does not affect the blood potassium level or the sensitivity of the heart to digoxin.

A. Morphine 6 mg IV push every 3 hr PRN acute pain. B. MS6 mg IV push every 3 hr PRN acute pain. C. MSO4 6 mg IV push every 3 hr PRN acute pain. D. Morphine 6.0 mg IV push every 3 hr PRN acute pain.

Correct Answer is A

Explanation

This is because it uses the full name of the drug, the exact dose, the route of administration, the frequency, and the indication for use. It also avoids any abbreviations that could be confused with other drugs or measurements.

Choice B is wrong because MS is an abbreviation for morphine sulfate which could be mistaken for magnesium sulfate.

Choice C is wrong because MSO4 is an abbreviation for morphine sulfate that could be mistaken for magnesium sulfate.

Choice D is wrong because 6.0 mg could be misread as 60 mg and lead to a tenfold overdose.

Normal ranges for morphine dosage depend on the route of administration, the indication, and the patient’s tolerance and response.

For acute pain, the usual oral dose is 10 to 30 mg every 4 hours as needed. For chronic pain, the usual oral dose is 15 to 30 mg every 8 to 12 hours as needed.

For intravenous (IV) administration, the usual dose is 2.5 to 15 mg every 4 hours as needed.

The morphine equivalent daily dose (MEDD) is a concept that attempts to establish an equivalency in terms of dose when comparing any opioid to morphine.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?

Correct Answer is C

Explanation

A nurse is receiving a medication prescription by telephone from a provider. The provider states, “Administer 6 milligrams of morphine IV push every 3 hours as needed for acute pain.” How should the nurse transcribe the prescription in the client’s medical record?

Correct Answer is A

Explanation

A nurse is caring for a 4-year-old child following an orthopaedic procedure. When assessing the child for pain, which of the following pain scales should the nurse use?

A nurse is administering naloxone to a client who has developed an adverse reaction to morphine. The nurse should identify which of the following findings is a therapeutic effect of naloxone?

A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus. Which of the following actions should the nurse take first?

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A nurse is providing teaching to a client who has a new prescription for paroxetine. The nurse should instruct the client to monitor for which of the following adverse effects?

A nurse is assessing a client’s IV infusion site and notes that the site is cool and edematous. Which of the following actions should the nurse take?

A nurse is providing teaching to a client who has a new prescription for theophylline, a sustained-release capsule. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is assessing a client who is receiving heparin via continuous IV. The client has an aPTT of 90 seconds. The nurse should monitor the client for which of the following changes in their vital signs?

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?