The nurse is providing education via phone to a client who called stating that the newly prescribed imipramine (Tofranil) is not working as depression is still a problem. Which question is most important to ask first?

"Are you feeling worse since taking the medication?"

"How long have you been taking the medication?"

"What time of day are you taking the medication?"

"What dosage of medication are you taking?"

Answer and Explanation

The Correct Answer is B

A. "Are you feeling worse since taking the medication?" This is an important safety question to ask, as it helps to assess whether the client’s condition has worsened since starting the medication. However, it is not the first priority when evaluating the efficacy of a newly prescribed antidepressant.

B. "How long have you been taking the medication?" This is the most important question to ask first because the effectiveness of imipramine, a tricyclic antidepressant, can take several weeks to become apparent. If the client has not been taking the medication for an adequate period, the drug may simply not have had enough time to work yet.

C. "What time of day are you taking the medication?" While the timing of the medication can affect side effects, it is less critical than knowing how long the client has been on the medication when assessing its effectiveness.

D. "What dosage of medication are you taking?" This is an important follow-up question but not the first priority. The duration of treatment is more critical to assess before considering dosage adjustments.

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Correct Answer is A

Explanation

A. "It will not produce sedation like benzodiazepines." Buspirone is a non-sedative anxiolytic, making it safer for long-term use compared to benzodiazepines, which can cause sedation and other CNS depressant effects. This is the best response as it directly addresses the patient's concern about safety.

B. "It produces anticonvulsant action to prevent convulsions." Buspirone does not have anticonvulsant properties, and this response does not address the patient’s question about safety compared to benzodiazepines.

C. "It produces muscle relaxant effects to decrease back pain." Buspirone does not have muscle relaxant effects, and this response does not directly answer the patient’s concern about the safety of the medication.

D. "It provides you with a sleep additive to decrease insomnia." Buspirone does not have significant sedative or hypnotic effects, making this response incorrect.

A. Monitoring the client for neuroleptic malignant syndrome for up to 2 months after initiating the drug. B. Encouraging the client to report signs of diabetes, such as increased thirst, hunger, and urination. C. Advising the client to report weight gain and skin rashes to the health care provider immediately. D. Using the Abnormal Involuntary Movement Scale (AIMS) to assess for neurologic adverse effects. E. Administering the medication subcutaneously when the client is unable to swallow effectively.

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

Explanation

A. Monitoring the client for neuroleptic malignant syndrome for up to 2 months after initiating the drug. Neuroleptic malignant syndrome (NMS) is a rare but serious adverse effect of antipsychotic medications. Monitoring for NMS, especially during the first few months of treatment, is crucial.

B. Encouraging the client to report signs of diabetes, such as increased thirst, hunger, and urination. Some antipsychotics, particularly second-generation antipsychotics, are associated with an increased risk of metabolic syndrome, including diabetes. Clients should be educated to report symptoms suggestive of hyperglycemia.

C. Advising the client to report weight gain and skin rashes to the health care provider immediately. Weight gain is a common side effect, particularly with second-generation antipsychotics. Skin rashes could indicate an allergic reaction, including serious conditions like Stevens-Johnson syndrome, requiring immediate medical attention.

D. Using the Abnormal Involuntary Movement Scale (AIMS) to assess for neurologic adverse effects. The AIMS scale is used to assess for tardive dyskinesia and other extrapyramidal symptoms, which are potential adverse effects of antipsychotic medications.

E. Administering the medication subcutaneously when the client is unable to swallow effectively. Antipsychotic medications are generally not administered subcutaneously. If a client cannot swallow, an alternative route such as intramuscular injection or an orally disintegrating tablet might be used.

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The nurse is providing education via phone to a client who called stating that the newly prescribed imipramine (Tofranil) is not working as depression is still a problem. Which question is most important to ask first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient's medication regimen for treatment of anxiety has been changed from a benzodiazepine to buspirone (BuSpar). The patient asks the nurse what makes this medication safer than the benzodiazepine he has taken. What is the nurse's best response?

Correct Answer is A

Explanation

When administering an antipsychotic medication to a client diagnosed with schizophrenia, which action would be most appropriate for the nurse to include in the client's plan of care? Select all that apply.

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

Explanation

As a nurse approaches the nurses' station, a client diagnosed with a delusional disorder raises his voice and says, "You're following me. What do you want?" To prevent escalating fear and anger, the nurse takes a nonthreatening posture and makes which response in a calm voice?

The nurse is assessing the client's pupils following a sports injury. Which of the following assessment findings indicates a neurologic concern? Select all that apply.

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