The nurse assesses the client for which clinical manifestation associated with a bone fracture?

Choice A reason: Acetaminophen reduces fever by acting on the hypothalamic thermoregulatory center but is ineffective for heat stroke, a hyperthermic emergency caused by environmental heat overload. It does not address core temperature elevation or systemic effects like dehydration and organ dysfunction, making it inappropriate for immediate heat stroke management.

Choice B reason: Removing the client’s clothing facilitates evaporative and convective cooling, critical in heat stroke where core body temperature exceeds 40°C. This intervention enhances heat dissipation from the skin, reducing the risk of organ damage from hyperthermia. It is a primary nursing action to lower body temperature effectively and safely.

Choice C reason: Placing a client with heat stroke in a hot bath would exacerbate hyperthermia, worsening organ damage and cardiovascular strain. Heat stroke requires rapid cooling via cold water immersion or evaporative methods, not additional heat exposure, making this intervention dangerous and contraindicated in this life-threatening condition.

Choice D reason: Encouraging oral fluids like cold water is inappropriate for a lethargic heat stroke patient, who may have impaired swallowing or consciousness, risking aspiration. Intravenous fluids are preferred to correct dehydration and electrolyte imbalances safely, as oral intake does not address the urgent need for rapid cooling and systemic stabilization.

Choice A reason: Monoamine oxidase inhibitors (MAOIs) require dietary restrictions to avoid tyramine-rich foods (e.g., aged cheese), which can cause hypertensive crisis by increasing norepinephrine release. MAOIs inhibit monoamine breakdown, amplifying tyramine’s effects. This statement is accurate, as dietary caution is critical to prevent serious adverse reactions.

Choice B reason: MAOIs, like phenelzine, take 2-6 weeks to improve depressive symptoms by increasing monoamine levels (serotonin, norepinephrine, dopamine). Immediate improvement does not occur due to gradual synaptic changes. This statement is inaccurate, as the delayed onset is a key characteristic of MAOIs, similar to other antidepressants.

Choice C reason: MAOIs are reserved for treatment-resistant depression when newer drugs like SSRIs fail, due to their side effect profile and dietary restrictions. They effectively increase monoamine availability but are less preferred due to safety concerns. This statement is accurate, reflecting their role in refractory cases.

Choice D reason: MAOIs can cause hypertensive crisis via drug interactions (e.g., with SSRIs or sympathomimetics), as they inhibit monoamine breakdown, leading to excessive norepinephrine. This can result in severe blood pressure elevation. This statement is accurate, as drug interactions are a significant risk with MAOI therapy.