A nurse is caring for an adolescent who is receiving treatment for burns and is requesting medication for pain. Which of the following questions should the nurse ask to determine the quality of the adolescent's pain?

"Can you describe what your pain feels like?"

"Can you point to the area where your pain is most severe?"

"What is your pain level on a scale of 0 to 10?"

"When did your pain start increasing?"

Answer and Explanation

The Correct Answer is A

A. Asking the adolescent to describe the quality of their pain can provide valuable information about the characteristics of the pain, such as sharp, dull, throbbing, or burning.
B. Asking the adolescent to point to the area of most severe pain assesses location, not quality.

C. Asking about pain level assesses intensity, not quality.

D. Asking about the timing of pain increasing assesses onset, not quality.

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Correct Answer is B

Explanation

A. Bruxism: Bruxism, or teeth grinding, is a potential adverse effect of citalopram but is generally less severe than confusion. While it should be monitored and reported if severe or persistent, it is not typically considered a priority adverse effect.
B. Confusion: Confusion can indicate a serious adverse reaction or complication, such as serotonin syndrome, which is a potentially life-threatening condition associated with the use of selective serotonin reuptake inhibitors (SSRIs) like citalopram. Therefore, confusion is the priority adverse effect to report to the provider.
C. Insomnia: Insomnia is a common side effect of citalopram and other SSRIs but is generally less severe than confusion. It should be monitored and reported if severe or persistent, but it is not typically considered a priority adverse effect.
D. Weight loss: Weight loss can occur as a side effect of citalopram but is generally less severe than confusion. It should be monitored and reported if excessive or rapid, but it is not typically considered a priority adverse effect.

A. Increased heart rate B. Excessive thirst C. Moist oral mucous membranes D. Decreased blood pressure

Correct Answer is C

Explanation

A. An increased heart rate can be a sign of dehydration and would not indicate that IV fluid replacement has been effective.
B. Excessive thirst is a symptom of dehydration and would not indicate that IV fluid replacement has been effective.
C. Moist oral mucous membranes indicate improved hydration status and are a positive response to IV fluid replacement.
D. Decreased blood pressure is a sign of dehydration and would not indicate that IV fluid replacement has been effective.

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A nurse is caring for an adolescent who is receiving treatment for burns and is requesting medication for pain. Which of the following questions should the nurse ask to determine the quality of the adolescent's pain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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