A client with depression is prescribed fluoxetine. On a return visit to the clinic, the client tells the nurse that he also just started taking St. John's wort to feel better. The nurse assesses the client for which of the following?

Correct Answer: C

Rationale: The correct answer is C: Serotonin syndrome. This is because both fluoxetine and St. John's wort increase serotonin levels in the brain, leading to a risk of serotonin syndrome - a potentially life-threatening condition characterized by symptoms such as confusion, agitation, sweating, and muscle twitching. Water intoxication (A) is not typically associated with these medications. Increased depressive symptoms (B) may occur if the client stops taking fluoxetine abruptly, but not specifically due to the combination with St. John's wort. Hypertensive crisis (D) is not a common concern with these medications.

Correct Answer: A

Rationale: The correct answer is A because hospice care focuses on enhancing the quality of life for patients with terminal illnesses and their families. It provides holistic support, including pain management, emotional and spiritual care, and practical assistance. By bringing up hospice care, the nurse is offering a compassionate approach that aims to ensure comfort and dignity for Holly during her end-of-life journey. Choice B is incorrect because hospice care does not necessarily mean the end of all treatments. It shifts the focus from curative treatments to palliative care, but it still provides medical support to manage symptoms and improve comfort. Choice C is incorrect as hospice care does not provide curative treatment. It focuses on comfort care and symptom management rather than trying to cure the terminal illness. Choice D is incorrect because hospice care is not about hastening death. It aims to provide support and comfort during the natural end-of-life process, not to aggressively end life.

Correct Answer: D

Rationale: The correct answer is D: Alzheimer's disease. Alzheimer's disease is the most prevalent mental disorder in the United States, affecting millions of individuals. It is a neurodegenerative disorder characterized by memory loss and cognitive decline. Schizophrenia (A) is less common than Alzheimer's disease. Bipolar disorder (B) and Dissociative fugue (C) are also less prevalent compared to Alzheimer's disease. Alzheimer's disease is specifically known for its high prevalence and impact on the population.

Correct Answer: B

Rationale: The correct answer is B: "I should eat small frequent meals if I get nauseated." This is correct because methadone can cause nausea as a side effect, and eating small, frequent meals can help alleviate this symptom. Option A is incorrect because alcohol should be avoided while on methadone therapy. Option C is incorrect as methadone should be taken with food to reduce gastrointestinal side effects. Option D is incorrect as constipation, not diarrhea, is a common side effect of methadone therapy.

Correct Answer: D

Rationale: The correct answer is D because the client requiring a sterile dressing change for a burn has the highest priority due to the risk of infection and potential complications. Sterile technique is crucial to prevent infections in burn wounds. Burn injuries can lead to sepsis if not properly managed. Clients receiving chemotherapy (Choice A) may require careful monitoring but do not have an immediate risk of infection like the burn client. A client who has had an appendectomy and has diminished bowel sounds (Choice B) may indicate a potential complication but is not as urgent as managing a burn wound. A client with hypothyroidism and stupor (Choice C) may require intervention but does not pose an immediate threat to life like a burn wound needing a sterile dressing change.