The client presents to the emergency department with a headache in the back of the head, diaphoresis, and neck stiffness. The client's blood pressure measures 180/124 mm Hg and heart rate is 168 beats/min. The spouse says the client is currently prescribed "something for depression" and denies any history of cardiac disease. The nurse should suspect the use of what medication?

A monoamine oxidase inhibitor (MAOI)

A selective serotonin reuptake inhibitor (SSRI)

A tricyclic antidepressant (TCA)

An atypical antipsychotic

None

Answer and Explanation

The Correct Answer is A

A.   MAOIs are a class of antidepressants that work by inhibiting the activity of monoamine oxidase, an enzyme that breaks down neurotransmitters such as serotonin, dopamine, and norepinephrine. MAOIs can interact with certain foods and other medications, potentially leading to a hypertensive crisis characterized by severe hypertension, headache, diaphoresis, and other symptoms.
B.   SSRIs are commonly prescribed antidepressants that work by increasing the levels of serotonin in the brain. Serotonin syndrome can present with symptoms such as headache, diaphoresis, tachycardia, and hyperthermia, but it typically doesn't cause severe hypertension.
C.   TCAs are another class of antidepressants that work by inhibiting the reuptake of serotonin and norepinephrine. TCAs can cause anticholinergic effects such as dry mouth, blurred vision, constipation, and urinary retention. However, TCAs are less commonly associated with severe hypertension compared to MAOIs.
D.   Atypical antipsychotics are used to treat various psychiatric disorders, including schizophrenia and bipolar disorder. While they are not typically associated with causing severe hypertension directly, they can have cardiovascular side effects such as tachycardia and orthostatic hypotension.

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Correct Answer is D

Explanation

D. The constant repetitive cleaning behavior observed in the client with OCD is likely an attempt to decrease anxiety associated with obsessive thoughts or fears of contamination.

A. While individuals with OCD may engage in compulsive behaviors to gain a sense of control over their environment, the primary motivation behind these behaviors is not to manipulate others.

B. While engaging in repetitive cleaning behaviors may occupy the client's time and attention, the primary purpose of these behaviors is not necessarily to decrease the time available for interaction with people.

C. While individuals with OCD may experience distress or anxiety related to their obsessions and may engage in compulsive behaviors to reduce these feelings, the goal is typically to alleviate anxiety

A. Talk to the client and identify the specific limits that are required of the client's behavior. B. Escort the client to her room each time the nurse observes the client socializing with other clients. C. Discuss the problem in a community meeting with the other clients on the unit present. D. Tell the other clients to ignore the client's lies.

Correct Answer is A

Explanation

A. Engaging in a conversation with the client allows the nurse to set clear expectations and boundaries. The nurse can explain the acceptable behavior and the consequences of disruptive actions. It’s essential to approach this conversation calmly and professionally.

B. While removing the client from social situations may temporarily prevent disruptive behavior, it does not address the underlying issue. Isolating the client may also negatively impact their well- being. It’s better to address the behavior directly rather than resorting to isolation.

C. Holding a community meeting involving all clients may not be appropriate or effective. It could escalate tensions and create an uncomfortable environment for everyone. Individualized interventions are more effective.

D. Ignoring disruptive behavior may not be the best approach. It’s essential to address the issue directly rather than expecting other clients to tolerate disruptive behavior.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A home-health nurse is assessing a client who has obsessive-compulsive disorder (OCD) and finds that the client demonstrates constant repetitive cleaning. The nurse knows that this behavior is an attempt to accomplish which of the following?

Correct Answer is D

Explanation

A nurse is caring for a hospitalized client who tells lies about other clients. The other clients on the unit frequently complain to the nursing staff about the client's disruptive behaviors. Which of the following initial actions should the nurse take?

Correct Answer is A

Explanation

A nurse is creating a plan of care for a client who is experiencing mania. Which of the following interventions should the nurse include in the plan? (Select all that apply.)

A nurse is caring for a client who has schizophrenia and generalized anxiety disorder. The client has a prescription for alprazolam 0.25 mg PO every 8 hr PRN anxiety. For which of the following client statements should the nurse consider administering alprazolam?

Which are common reasons why abused persons remain with an abusive partner? Select all that apply.

A nurse in a hospital is caring for a client who has agoraphobia. Which of the following statements by the client indicates understanding of the goals of treatment?

A nurse is caring for a client with delirium who is experiencing illusions. What environmental conditions should the nurse arrange for this client?

A client with borderline personality disorder says to the nurse, "I feel so comfortable talking with you. You seem to have a special way about you that really helps me." Which would be the most appropriate response by the nurse?

A nurse is teaching a client who has a new prescription for disulfiram (Antabuse). Which of the following information should the nurse include in the teaching?