The client is prescribed phenelzine (Nardil). The client tells the nurse that they consumed two glasses of Chianti (red) wine at lunchtime. What is the nurse's priority action?

Discuss how food can increase the symptoms of depression

Arrange for admittance to the psychiatric unit

Discuss the effects of wine on the action of antidepressants

Assess the client's blood pressure

Answer and Explanation

The Correct Answer is D

Explanation:

A. Discussing how food can increase the symptoms of depression is not the priority in this situation; the immediate concern is the interaction between phenelzine and wine.

B. Admitting the client to the psychiatric unit is not necessary based solely on the consumption of wine with phenelzine; assessing the client's condition is the priority.

C. Discussing the effects of wine on the action of antidepressants is important, but assessing the client's current status takes precedence.

D. Assessing the client's blood pressure is the priority action because phenelzine is an MAOI, and consuming wine while taking MAOIs can lead to a hypertensive crisis.

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Correct Answer is D

Explanation

A. Taking cholestyramine with food may interfere with its absorption, reducing its effectiveness.

B. Taking cholestyramine without food is not typically recommended.

C. Taking cholestyramine in the morning is not specifically indicated; it can be taken at any time of the day.

D. Taking cholestyramine with large amounts of fluid helps prevent gastrointestinal side effects and improves its effectiveness in lowering cholesterol levels.

A. Blood pressure 130/80 B. States knee pain is currently a 5/10 (on a 0 to 10 pain intensity scale) C. Hypoactive bowel sounds X4 D. Complains of muscle weakness

Correct Answer is D

Explanation

Explanation:

A. A blood pressure of 130/80 is within the target range (below 140/90 for most individuals) and does not require immediate follow-up.

B. Knee pain, while important, is not an immediate priority compared to potential medication side effects or complications.

C. Hypoactive bowel sounds, while needing monitoring, are not typically a priority over potential adverse effects of medication.

D. Complaints of muscle weakness could indicate a potential side effect of atorvastatin (Lipitor), which should be promptly addressed to prevent complications such as rhabdomyolysis. Therefore, it is the priority assessment finding for the nurse to follow-up.

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The client is prescribed phenelzine (Nardil). The client tells the nurse that they consumed two glasses of Chianti (red) wine at lunchtime. What is the nurse's priority action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client is going to be started on cholestyramine (Questran), 6 mg three times daily.What instruction should the nurse provide to this client?

Correct Answer is D

Explanation

Correct Answer is D

Explanation

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