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Exhibits

The nurse evaluates the client and begins preparing for her discharge.

Choose the most likely options for the information missing from the statements by selecting from the lists provided.

The nurse teaches the client that it will take

for the sertraline to reach full therapeutic effect and explains the client has been set up to receive and reprocessing as an outpatient. The nurse also teaches the client to complement the medication and therapy.
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C","dropdown-group-3":"B"}

Rationale for Correct Choices

  • 4 to 8 weeks: Sertraline, an SSRI, typically requires 4 to 8 weeks to reach its full therapeutic effect. This time frame allows for sufficient serotonin modulation, necessary for symptom improvement in conditions like PTSD and depression.
  • Eye movement desensitization: Eye Movement Desensitization and Reprocessing (EMDR) is specifically recommended for PTSD. It involves guided eye movements that help the brain reprocess traumatic events and reduce emotional disturbance.
  • Deep breathing: Deep breathing promotes parasympathetic nervous system activation, helping reduce anxiety and hyperarousal. It is a simple, accessible coping strategy to complement therapy and medication.

Rationale for Incorrect Choices

  • 1 to 2 days: This timeframe is too short for an SSRI to have significant therapeutic effects. Any changes in mood or anxiety within this period are typically not due to the medication’s primary mechanism of action.
  • 10 to 14 days: Although some mild improvement may begin, full therapeutic benefits of sertraline are not typically seen within this period. Clients are advised to continue consistent use for several weeks.
  • Cognitive behavioural therapy: CBT is effective for many mental health disorders, including PTSD, but it does not involve the “reprocessing” component referenced.
  • Prolonged exposure therapy: Prolonged exposure is used for PTSD treatment but focuses on gradually confronting trauma-related memories. It lacks the reprocessing element emphasized in the question.
  • Progressive muscle relaxation: While useful for anxiety reduction, it is more complex and less immediate than deep breathing. It also requires a quiet space and more time, which may limit spontaneous use.
  • Guided imagery: Guided imagery can reduce anxiety but involves visualization, which may not be suitable for individuals with intrusive trauma-related images. Deep breathing is simpler and more universally applicable.


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Related Questions

Correct Answer is A

Explanation

Rationale:
A. Decrease consumption of red meat and most seafood: These foods are high in purines, which are metabolized into uric acid. Reducing purine intake helps lower uric acid levels, minimizing the frequency and severity of gout flares.

B. Support joints in an extended position while resting: Keeping joints in an extended position may worsen discomfort and inflammation. During acute attacks, joints should be rested in a slightly flexed, supported position to relieve pressure.

C. Massage joints to relax muscles and decrease pain: Massage of an inflamed joint during a gout attack can increase pain and inflammation. The affected area is usually extremely sensitive and should be protected, not manipulated.

D. Replace dietary table salt with salt substitutes: Salt substitutes often contain potassium, which can interact with medications like NSAIDs or ACE inhibitors. This recommendation is unrelated to gout management.

Correct Answer is D

Explanation

Rationale:

A. A change in the sleep-wake cycle: This is a common and expected effect as ramelteon works by regulating the circadian rhythm through melatonin receptors. It does not typically warrant immediate provider notification.

B. Dizziness reported after initial dose: Dizziness is a known, mild side effect that often resolves with continued use. It should be monitored but does not require urgent reporting unless severe or persistent.

C. Mild sedation: Sedation is an intended pharmacologic effect of ramelteon, helping to induce sleep. Mild sedation is not concerning unless excessive or impairing functioning.

D. Somnambulism: Sleepwalking (somnambulism) is an abnormal and potentially dangerous parasomnia that should be reported immediately. It can result in injury and may indicate the need to discontinue or adjust the medication.

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