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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
The air bubble should not be expelled from the syringe before administering enoxaparin. The air bubble is included to ensure that the entire dose is administered and to help prevent leakage of the medication into the subcutaneous tissue, which can reduce bruising.
Choice B rationale:
After administering enoxaparin, applying firm pressure (but not massaging) to the injection site helps minimize bruising and bleeding. It's important not to massage the site as this can increase the risk of bleeding.
Choice C rationale:
The needle should be inserted fully into the subcutaneous tissue at a 90-degree angle (or at a 45-degree angle if the client has little subcutaneous tissue). Inserting the needle halfway may result in improper administration.
Choice D rationale:
Enoxaparin is a low-molecular-weight heparin that should be administered subcutaneously, not intramuscularly. Administering it intramuscularly could increase the risk of bleeding and is not the appropriate route for this medication.
Correct Answer is A
Explanation
This is because fentanyl transmucosal is a fast-acting opioid that can be used for breakthrough pain in patients who are already receiving opioids for chronic pain. Breakthrough pain is a sudden and severe increase in pain that occurs despite the use of regular pain medication. Fentanyl transmucosal has a rapid onset of action (1-3 minutes) and a short duration of effect (1-2 hours), which makes it suitable for treating episodic pain.
Choice B. Lidocaine patch is wrong because lidocaine patch is a topical anesthetic that can be used for localized neuropathic pain, but not for acute or severe pain.
Choice C. Morphine tablet is wrong because morphine tablet is a long-acting opioid that can be used for chronic pain, but not for breakthrough pain. Morphine tablet has a slow onset of action (30-60 minutes) and a long duration of effect (3-4 hours), which makes it unsuitable for treating episodic pain.
Choice D. Naloxone IV is wrong because naloxone IV is an opioid antagonist that can reverse the effects of opioids, but not relieve pain.
Naloxone IV can cause
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