In conducting the initial assessment of a preoperative client, the nurse notes that the client's home medications include the monoamine oxidase (MAO) inhibitor phenelzine. Because of this client's medication history, which assessment finding is most important for the nurse to monitor?

Urinary output.

Blood pressure.

Respiratory rate.

Temperature

Answer and Explanation

The Correct Answer is B

A.   Urinary output might be important in some contexts but is not the priority related to the use of MAO inhibitors.
B.   MAO inhibitors like phenelzine can affect blood pressure significantly; monitoring BP is crucial due to the risk of hypertensive crisis when certain foods or medications are taken.
C.   Respiratory rate might be a consideration in some situations but is not directly affected by MAO inhibitors.
D.   Temperature is not typically a primary concern related to MAO inhibitor use; blood pressure monitoring is more crucial due to potential interactions.

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Correct Answer is B

Explanation

A. Inquiring about the mother's other children might not directly address her current emotional distress and might not be an immediate concern.
B. Asking if the mother has ever thought about harming herself or her child is essential to assess the severity of her depressive thoughts and the risk of harm.
C. Encouraging journaling can be helpful as part of coping, but in this context, addressing immediate concerns about self-harm is more crucial.
D. Reassurance is important, but in this case, providing false hope or assurance about achieving milestones may not be realistic and might not address the mother's current distress.

A. Explore changes in life that have occurred after the loss. B. Suggest the need for a psychiatric consultation. C. Offer a referral to pastoral counseling. D. Encourage attending a local support group.

Correct Answer is A

Explanation

A. Exploring changes in life after the loss can help the nurse understand the client's current situation and provide a basis for further interventions.
B. Suggesting psychiatric consultation might be necessary but might not be the immediate first step without assessing the client's current needs.
C. Offering a referral to pastoral counseling might be helpful, but understanding the client's current state is important before making specific referrals.
D. Encouraging attendance at a local support group could be beneficial but might not be the immediate priority without understanding the client's current emotional state.

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In conducting the initial assessment of a preoperative client, the nurse notes that the client's home medications include the monoamine oxidase (MAO) inhibitor phenelzine. Because of this client's medication history, which assessment finding is most important for the nurse to monitor?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The mother of an 8-month-old infant with profound mental and physical disabilities tells the nurse how depressed she is because she realizes that her child will never achieve normal growth and development milestones. How should the nurse respond to this mother?

Correct Answer is B

Explanation

The nurse is caring for a client who is experiencing extreme sadness after the passing of a companion of 30 years. The client describes not being able to think of other things and finds it difficult to control emotions. Which action should the nurse take first?

Correct Answer is A

Explanation

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