The nurse is providing education via phone to a client who called stating that the newly prescribed imipramine (Tofranil) is not working as depression is still a problem. Which question is most important to ask first?

"Are you feeling worse since taking the medication?"

"How long have you been taking the medication?"

"What time of day are you taking the medication?"

"What dosage of medication are you taking?"

Answer and Explanation

The Correct Answer is B

A. "Are you feeling worse since taking the medication?" This is an important safety question to ask, as it helps to assess whether the client’s condition has worsened since starting the medication. However, it is not the first priority when evaluating the efficacy of a newly prescribed antidepressant.

B. "How long have you been taking the medication?" This is the most important question to ask first because the effectiveness of imipramine, a tricyclic antidepressant, can take several weeks to become apparent. If the client has not been taking the medication for an adequate period, the drug may simply not have had enough time to work yet.

C. "What time of day are you taking the medication?" While the timing of the medication can affect side effects, it is less critical than knowing how long the client has been on the medication when assessing its effectiveness.

D. "What dosage of medication are you taking?" This is an important follow-up question but not the first priority. The duration of treatment is more critical to assess before considering dosage adjustments.

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Correct Answer is B

Explanation

A. A client who has recently begun treatment with propranolol (Inderal) for the treatment of social phobia. Propranolol, a beta-blocker, does not have a significant risk for dependence or withdrawal symptoms. It is primarily used for physical symptoms of anxiety, such as tachycardia.

B. A woman who has been taking lorazepam (Ativan) for several months after witnessing a traumatic motor vehicle accident. Lorazepam is a benzodiazepine, which has a high potential for dependence and withdrawal, especially with long-term use. This client is the most at risk for these issues.

C. A man whose obsessive-compulsive disorder (OCD) is being treated long-term with paroxetine (Paxil). While discontinuation symptoms can occur with SSRIs like paroxetine, the risk of dependence is significantly lower than with benzodiazepines.

D. A client with generalized anxiety disorder who has responded well since beginning treatment with fluoxetine (Prozac) earlier in the year. Like paroxetine, fluoxetine is an SSRI, and while discontinuation symptoms may occur, the risk of dependence is low.

A. Asian men B. White women C. Native American men D. African American women

Correct Answer is D

Explanation

A. Asian men: SLE is less common in men and even less common among Asian men.

B. White women: White women are at risk, but SLE is more prevalent among women of African descent.

C. Native American men: SLE is more common in women, and while Native Americans have a higher risk compared to some other groups, African American women have the highest prevalence.

D. African American women: This group has the highest risk for developing SLE. The disease is more common and severe in African American women compared to other demographics.

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The nurse is providing education via phone to a client who called stating that the newly prescribed imipramine (Tofranil) is not working as depression is still a problem. Which question is most important to ask first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following clients is most likely to be at risk for drug dependence and difficulties with withdrawal?

Correct Answer is B

Explanation

A nurse is assisting in preparing a presentation at a community center about systemic lupus erythematosus (SLE). The nurse should identify which of the following groups as having the highest risk for developing this disorder?

Correct Answer is D

Explanation

When administering an antipsychotic medication to a client diagnosed with schizophrenia, which action would be most appropriate for the nurse to include in the client's plan of care? Select all that apply.

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