The client has been diagnosed with severe depression and prescribed sertraline (Zoloft). Which assessment of the client by the nurse is a priority after initiation of the medication?
Increased sleep
Suicidal ideations
Emotional changes
Increased socialization
The Correct Answer is B
Choice A reason: Increased sleep may occur with sertraline due to its sedative effects, but it is not the priority assessment. Early in treatment, SSRIs can increase energy before mood improvement, heightening suicide risk, making suicidal ideation a more urgent concern.
Choice B reason: Sertraline, an SSRI, can initially increase energy in severe depression before fully improving mood, potentially increasing suicide risk. Assessing suicidal ideation is the priority to ensure safety, as this risk is highest early in treatment, requiring immediate intervention if present.
Choice C reason: Emotional changes are expected with sertraline as it improves mood over weeks. However, this is less urgent than assessing suicidal ideation, which poses an immediate safety risk, especially in severe depression during the early phase of SSRI treatment.
Choice D reason: Increased socialization may indicate improved depressive symptoms but is a secondary outcome. The priority is assessing suicidal ideation, as SSRIs can paradoxically increase suicide risk early in treatment due to improved energy without full mood stabilization, requiring vigilant monitoring.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Lorazepam, a benzodiazepine, reduces anxiety via GABA enhancement but is not specifically indicated for PTSD-related nightmares. It carries a risk of dependence and may worsen sleep architecture, making it less effective for this symptom compared to targeted medications.
Choice B reason: Prazosin, an alpha-1 adrenergic blocker, reduces norepinephrine-driven hyperarousal in PTSD, significantly decreasing nightmare frequency and intensity. It targets the sympathetic nervous system’s role in PTSD sleep disturbances, making it the most effective choice for this symptom.
Choice C reason: Fluoxetine, an SSRI, treats PTSD symptoms like depression and anxiety by increasing serotonin levels. While effective for overall PTSD management, it is less specific for nightmares compared to prazosin, which directly targets sleep-related hyperarousal.
Choice D reason: Lithium is used for bipolar disorder to stabilize mood via neurotransmitter modulation. It does not specifically address PTSD nightmares, which are driven by hyperarousal, making it an ineffective choice compared to prazosin’s targeted action on nightmares.
Correct Answer is ["1.44"]
Explanation
Step 1: Calculate the total units to be given per hour: 18 × 90 = 1620 units/hour Result = 1620 units/hour
Step 2: Determine the concentration of Heparin in 1 mL: 25000 ÷ 250 = 100 units/mL Result = 100 units/mL
Step 3: Calculate the required volume in mL/hr using total units per hour: (1620 ÷ 100) = 16.2 mL/hr Result = 16.2 mL/hr
Final answer 16.2 mL/hr
Question 47
Calculate the initial bolus of Heparin. Heparin is ordered as 80 units/kg. The client weighs 90 kg. How many mL would you administer using a vial of Heparin labeled Heparin 5000 units/mL?
The correct answer is 1.44 mL
Explanation:
Step 1: Calculate the total number of units required for the bolus: 80 × 90 = 7200 units Result = 7200 units
Step 2: Use the vial concentration to find out how many mL deliver 7200 units: (7200 ÷ 5000) = 1.44 mL Result = 1.44 mL
Final answer 1.44 mL
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