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

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A reason: Resuming vigorous activity like tennis one week post-pacemaker insertion risks lead dislodgement, as the device requires time to stabilize. Arm movements in tennis, especially overhead swings, can disrupt the pacemaker leads, making this advice unsafe and inappropriate.

Choice B reason: Suggesting hockey or skating as alternatives is incorrect, as these activities also involve significant physical exertion and risk of trauma to the pacemaker site. Additionally, delaying until fall is arbitrary, and these sports do not reduce the risk of lead dislodgement compared to tennis.

Choice C reason: Substituting tennis with basketball or football is inappropriate, as these contact sports pose a higher risk of trauma to the pacemaker site, potentially causing device malfunction or lead dislodgement. These activities are not safer alternatives and could exacerbate complications.

Choice D reason: Restricting arm movement above the head for two weeks post-pacemaker insertion prevents lead dislodgement, as the leads need time to anchor in the heart tissue. Tennis involves vigorous arm motions, so canceling the tournament is necessary to ensure device stability and client safety.

A. Nausea and vomiting B. Hypertension and headache C. Flattened neck veins D. Hypotension and dizziness

Correct Answer is D

Explanation

Choice A reason: Nausea and vomiting can occur in cardiac conditions due to reduced perfusion to the gastrointestinal system. However, in atrial fibrillation with a rapid ventricular rate, the priority is assessing for symptoms of reduced cardiac output, such as hypotension and dizziness, which are more immediate and life-threatening.

Choice B reason: Hypertension and headache are not typical of rapid atrial fibrillation, which usually causes reduced cardiac output due to ineffective atrial contractions. These symptoms are more associated with hypertensive crises or other conditions, making them less relevant for this dysrhythmia.

Choice C reason: Flattened neck veins suggest hypovolemia or low venous pressure, not typical in acute atrial fibrillation, where jugular vein distension may occur due to heart failure. Hypotension and dizziness are more direct indicators of compromised cardiac output in this scenario.

Choice D reason: Rapid atrial fibrillation impairs atrial filling, reducing cardiac output and causing hypotension. Dizziness results from decreased cerebral perfusion due to low blood pressure. These are critical symptoms to assess, as they indicate hemodynamic instability, requiring immediate intervention to prevent further complications.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. The client, an avid tennis player, is scheduled to play in a tournament in one week. What teaching should the nurse provide to the client related to this activity?

Correct Answer is D

Explanation

A nurse is caring for a client who suddenly develops atrial fibrillation with a ventricular rate of 150 beats per minute. The nurse should assess the client for which of the following priority signs and symptoms associated with this dysrhythmia?

Correct Answer is D

Explanation

The nurse is providing discharge instructions to a client who is prescribed lisinopril, an ACE inhibitor. Which statement by the client demonstrates proper understanding of the discharge instructions?

A nurse is caring for a client with a ventricular pacemaker who is on ECG monitoring. The nurse understands that the pacemaker is functioning properly when which of the following appears on the monitor strip?

A client with depression is prescribed phenelzine (Nardil). The client says to the nurse, “I will need to watch my diet with this medication. What food options should I avoid?” Which of the following is the correct response by the nurse?

A client with heart failure is taking an angiotensin-converting enzyme inhibitor (ACE-I) and reports a nagging cough. Which replacement medication will the nurse expect to be prescribed for this client?

Which statement is true?

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