A nurse is collecting data from a client who reports feeling stress. Which of the following should the nurse identify as an external stressor?

Explanation

A. Turn cellular phones to silent mode

Staff members should be advised to silence their cellular phones during an active shooter situation. This helps maintain silence and prevents the ringing or vibrating of phones from potentially revealing the location of individuals hiding or seeking shelter.

Move wounded clients to a safe area before finding shelter in (option B) is not correct. In the event of an active shooter situation. The safety of both staff members and clients is paramount. If it can be done quickly and without putting oneself or others at significant risk, moving wounded clients to a safe area before finding shelter may be advisable. However, the primary focus should be on finding shelter and protecting oneself from harm.

Attempt to bargain with the shooter in (option C) is not correct. Engaging in negotiations or attempting to reason with an active shooter can be extremely dangerous and may escalate the situation. Staff members should be instructed to prioritize their own safety and follow established active shooter protocols, which often involve evacuating, hiding, or acting to incapacitate or disable the shooter as a last resort.

Wave hands to attract the attention of law enforcement in (option D) is not correct. Waving hands or making sudden movements that may be misconstrued as threatening can potentially result in harm or confusion when law enforcement or security personnel are responding to an active shooter situation. It is important to follow their instructions calmly and clearly, keeping hands visible and following their guidance to ensure everyone's safety.

In summary, the nurse should recommend turning cellular phones to silent mode, moving wounded clients to a safe area if possible, not attempting to bargain with the shooter, and avoiding actions that may be misinterpreted by law enforcement. These recommendations are aimed at prioritizing personal safety and following established protocols to minimize risks during an active shooter situation.

Explanation

B.Hypertension

Tranylcypromine is a monoamine oxidase inhibitor (MAOI) used to treat depression. One of the potential adverse effects of MAOIs is hypertensive crisis, which can be triggered by the consumption of foods high in tyramine. Tyramine-rich foods, such as aged cheeses, cured meats, certain wines, and fermented products, can cause the release of norepinephrine, leading to a sudden increase in blood pressure.

Monitoring the client for hypertension is crucial because a hypertensive crisis can be life-threatening. Signs and symptoms of hypertensive crisis may include severe headache, chest pain, palpitations, blurred vision, anxiety, and shortness of breath. If these symptoms occur, immediate medical intervention is required.

The other options are not specifically associated with the adverse effects of tranylcypromine:

Hyperglycemia in (option A) is not typically associated with tranylcypromine. However, it is important to monitor blood glucose levels in clients with pre-existing diabetes, as tranylcypromine can affect blood sugar control.

Hematuria (blood in the urine) in (option C) is not a common adverse effect of tranylcypromine.

Tinnitus (ringing in the ears) in (option D) is not a commonly reported adverse effect of tranylcypromine.