A nurse is assessing a client who has been taking sertraline for 2 weeks. The nurse should identify which of the following findings as an indication that the medication is effective?

The client's blood pressure is within the expected reference range.

The client's legs are not swollen.

The client reports a recent weight loss

The client reports increase in mood.

Answer and Explanation

The Correct Answer is D

A. The client's blood pressure is within the expected reference range - While blood pressure monitoring is important during treatment with certain medications, such as antihypertensives, it is not a direct indicator of the effectiveness of sertraline, which is an antidepressant medication.

B. The client's legs are not swollen - Swelling of the legs may be a sign of fluid retention, which can occur with various conditions and medications. However, it is not a specific indicator of the effectiveness of sertraline.

C. The client reports a recent weight loss - Weight changes, including weight loss or gain, can occur as side effects of sertraline. However, weight changes alone do not necessarily indicate the effectiveness of the medication in treating depression.

D. The client reports an increase in mood - Improvement in mood, reduction in depressive symptoms, and overall sense of well-being are primary indicators of the effectiveness of sertraline and other antidepressant medications in treating depression. Therefore, the client reporting an increase in mood suggests that the medication may be effective in managing their symptoms.

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Correct Answer is C

Explanation

A. Prepare for gastric lavage due to an extremely elevated lithium level.

This option is incorrect. A lithium level of 1.0 mEq/L is within the therapeutic range for treating bipolar disorder or other mood disorders. Gastric lavage (stomach pumping) is not indicated for this level of lithium concentration.

B. Check the client's medication record to assess whether the client has been refusing her lithium.

This option is not directly relevant to the client's current lithium level of 1.0 mEq/L. While it's important to monitor medication adherence, the client's lithium level is within the therapeutic range, so there is no immediate concern about refusal or non-adherence.

C. Administer the morning dose of lithium.

This option is correct. With a lithium level of 1.0 mEq/L, which falls within the therapeutic range for treating bipolar disorder, the nurse should proceed with administering the morning dose of lithium as prescribed. It's important to maintain therapeutic lithium levels to effectively manage the client's condition.

D. Hold the medication and assess for early manifestations of toxicity.

This option is incorrect. With a lithium level of 1.0 mEq/L, there is no indication to hold the medication or suspect early manifestations of toxicity. Monitoring for lithium toxicity is important, but it's not warranted in this scenario where the lithium level is within the therapeutic range.

Correct Answer is ["75"]

Explanation

To calculate the infusion rate in mL/hr for total parenteral nutrition (TPN) we divide the total volume by the total infusion time.

Given: Total volume of TPN = 1800 mL Total infusion time = 24 hours

Infusion rate (mL/hr) = Total volume / Total infusion time

Substituting the given values: Infusion rate = 1800 mL / 24 hr ≈ 75 mL/hr

Rounded to the nearest whole number, the nurse should set the IV pump to deliver approximately 75 mL/hr of TPN.

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A nurse is assessing a client who has been taking sertraline for 2 weeks. The nurse should identify which of the following findings as an indication that the medication is effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an acute care mental health facility is preparing to administer morning medication for a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is preparing to administer total parental nutrition (TPN) 1800 mL to infuse over 24 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["75"]

Explanation

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