A nurse on a mental health unit is caring for a client.

Exhibits

For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client. There must be at least 1 selection in every row. There does not need to be a selection in every column.

Bupropion 100 mg, PO three times daily

Levomilnacipran 20 mg PO daily

Citalopram 20 mg PO daily

Fluoxetine 20 mg PO daily

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"}}

Potential prescription	Anticipated	Contraindicated
Bupropion 100 mg PO three times daily		✓
Levomilnacipran 20 mg PO daily	✓
Citalopram 20 mg PO daily	✓
Fluoxetine 20 mg PO daily	✓

Rationale

Bupropion 100 mg PO three times daily: Contraindicated
- Bupropion is generally contraindicated for clients with a history of bulimia nervosa due to the increased risk of seizures.
Levomilnacipran 20 mg PO daily: Anticipated
- Levomilnacipran is an SNRI that can be used to treat major depressive disorder and is generally safe for clients with bulimia nervosa.
Citalopram 20 mg PO daily: Anticipated
- Citalopram is an SSRI commonly used to treat major depressive disorder and can be effective for clients with bulimia nervosa.
Fluoxetine 20 mg PO daily: Anticipated
- Fluoxetine is an SSRI that is effective in treating both major depressive disorder and bulimia nervosa.

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Correct Answer is B

Explanation

A. Sinus tachycardia: Incorrect. Sinus tachycardia shows a regular rhythm with identifiable P waves, not a wavy baseline.

B. Atrial fibrillation: The wavy baseline and absent P waves are characteristic of atrial fibrillation, a common arrhythmia that results from rapid and irregular electrical activity in the atria.

C. Second-degree heart block: Incorrect. Second-degree heart block would show P waves with intermittent conduction of the QRS complex, not a wavy baseline.

D. Ventricular asystole: Incorrect. Ventricular asystole would show no electrical activity, which is different from a wavy baseline.

A. Pain score B. Vaginal bleeding characteristics C. Hematocrit D. Abdominal assessment E. Hemoglobin F. Blood pressure

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A,B"},"D":{"answers":"B"},"E":{"answers":"A,B"},"F":{"answers":"A,B"}}

Explanation

Assessment findings	Placenta previa	Abruptio placenta
Pain score		✅
Vaginal bleeding characteristics		✅
Hematocrit	✅	✅
Abdominal assessment		✅
Hemoglobin	✅	✅
Blood pressure	✅	✅

Rationale:

Pain: The client has abdominal pain, rated 7/10, which is sharp and associated with uterine hypertonicity and tenderness in the left upper quadrant. Placenta previa typically presents with painless bleeding and minimal to no abdominal pain, while abruptio placenta involves severe pain due to placental separation.

Vaginal bleeding: Dark red vaginal bleeding was reported. Placenta previa results in painless bright red bleeding, while abruptio placenta presents with dark red bleeding often accompanied by clots and associated pain.

Hemoglobin: Hemoglobin is 8.1 g/dL, which is low (normal range: 12 to 16 g/dL), indicating blood loss or hemorrhage. Both conditions can lead to low hematocrit and hemoglobin, but abruptio placenta may cause more significant blood loss, leading to a greater decrease in these values.

Hematocrit: The hematocrit is 24%, which is also low (normal range: 36% to 47%), further suggesting blood loss. Both conditions can lead to low hematocrit and hemoglobin, but abruptio placenta may cause more significant blood loss, leading to a greater decrease in these values.

Abdominal assessment: Placenta previa tends to show a soft abdomen with no tenderness, while abruptio placenta causes rigid, board-like abdominal muscles with tenderness, often localized.

Blood Pressure: Blood pressure is 95/62 mm Hg, which is on the lower side but not critically low. Placenta previa typically has normal or slightly low blood pressure, while abruptio placenta can cause hypotension due to significant blood loss and shock.

Fetal Heart Rate: FHR is 116/min, with minimal variability noted, which may indicate fetal distress which can be seen in both conditions.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is alert and oriented and is receiving continuous ECG monitoring. The cardiac rhythm strip shows a wavy baseline, no distinguishable P waves, and an increased heart rate. The nurse should identify the cardiac rhythm as which of the following?

Correct Answer is B

Explanation

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A,B"},"D":{"answers":"B"},"E":{"answers":"A,B"},"F":{"answers":"A,B"}}

Explanation

A nurse is providing preoperative teaching to an older adult client who is scheduled for surgery. Which of the following actions should the nurse take to promote learning?

A nurse is assessing the coping strategies of a client who has recently retired. Which of the following statements by the client indicates that the client is using compensation as a defense mechanism?

A nurse is planning care for a client who sustained a major burn over 20% of the body. Which of the following interventions should the nurse include to support the client's nutritional requirements?

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A nurse is preparing to admit a 6-year-old with varicella to the pediatric unit. Which of the following actions should the nurse take?

A nurse is providing preoperative teaching to a client about the administration of morphine via a PCA pump. Which of the following statements by the client indicates an understanding of the teaching?

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