A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?

Correct Answer: B

Rationale: The correct answer is B because amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, thus helping to prevent the transmission of pain impulses to the brain. This mechanism of action is effective in managing neuropathic pain, such as burning foot pain in diabetic patients. Choices A, C, and D are incorrect because amitriptyline's primary mechanism of action is related to its effects on neurotransmitter reuptake, not directly related to mood improvement, blood vessel changes, or sleep improvement.

Correct Answer: C

Rationale: The correct answer is C: medical-legal incident. When a client discharges AMA, it poses medical-legal risks for healthcare providers. This includes potential liability if the client experiences adverse outcomes post-discharge. Other choices are incorrect because discharging AMA is not solely focused on nurses (A) or physicians (B), but involves legal implications. It is also not purely patient-focused (D) as it impacts the healthcare team's legal responsibilities.

Correct Answer: B

Rationale: The correct answer is B because amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, thus helping to prevent the transmission of pain impulses to the brain. This mechanism of action is effective in managing neuropathic pain, such as burning foot pain in diabetic patients. Choices A, C, and D are incorrect because amitriptyline's primary mechanism of action is related to its effects on neurotransmitter reuptake, not directly related to mood improvement, blood vessel changes, or sleep improvement.

Correct Answer: B

Rationale: The correct answer is B: Rejection of the job. Turnover can occur when employees feel dissatisfied with their job roles, responsibilities, or work environment, leading them to reject the job and seek opportunities elsewhere. This perception aligns with the concept of voluntary turnover, where employees choose to leave due to personal reasons rather than external factors like poor management (A), loss of poor performers (C), or poor job atmosphere (D). These other choices focus on external factors or outcomes of turnover, whereas choice B directly addresses the personal perspective of the employee as a key driver of turnover.

Correct Answer: B

Rationale: The correct answer is B: Assessment. The first step in resolving an ethical dilemma is to thoroughly assess the situation. This involves gathering all relevant information, understanding the perspectives of the patient and family, and identifying key ethical principles at stake. Assessment allows the RN to have a clear understanding of the dilemma and its implications before proceeding with any planning, implementation, or evaluation. Planning (A), Implementation (D), and Evaluation (C) are all important steps in the problem-solving process, but without a comprehensive assessment, the RN may not have a solid foundation to address the ethical dilemma effectively.

Correct Answer: A

Rationale: The correct answer is A: Use antimicrobial sanitizer for hand hygiene. Hand hygiene is crucial in preventing the spread of tuberculosis. TB is transmitted through respiratory droplets, not contact, so wearing a mask (choice B) is not effective. Limiting visitor time (choice C) may help reduce exposure, but hand hygiene is more critical. Wearing gloves for oral care (choice D) is important for standard precautions, but hand hygiene is the priority for TB prevention.

Correct Answer: B

Rationale: The correct answer is B because a blood pressure of 146/88 mmHg indicates hypertension, which is a common complication of diabetes. High blood pressure can lead to cardiovascular complications and may warrant a change in therapy. A: Hemoglobin A1C level 6.2% is within the target range for diabetes control. C: Resting heart rate of 58 beats/minute is within the normal range for an active individual. D: HDL level of 65 mg/dL is considered high and is actually beneficial for cardiovascular health.

Correct Answer: D

Rationale: The correct answer is D: Autocratic leadership. In a high-stress, time-sensitive situation like a multiple-car accident with multiple trauma clients, autocratic leadership is most effective due to its clear chain of command and quick decision-making. The leader can provide swift direction, prioritize tasks, and ensure immediate action to save lives. Democratic leadership (A) may lead to delays in decision-making. Bureaucratic leadership (B) focuses on following procedures, which may not be suitable for urgent situations. Laissez-faire leadership (C) lacks direction and can result in chaos in a crisis.

Correct Answer: D

Rationale: The correct answer is D: Patient-focused. Developing a patient-focused atmosphere is crucial to reduce potential risks in healthcare. Patients should be at the center of care, with their needs, preferences, and safety prioritized. In a patient-focused atmosphere, communication is enhanced, leading to better understanding and adherence to treatment plans, reducing errors and adverse events. Nurses, physicians, and families play important roles in patient care, but ultimately, the patient should be the primary focus. Incorrect choices: A: Nurse-focused - Focusing solely on nurses may neglect the holistic approach to patient care and fail to address the patient's needs directly. B: Physician-focused - Similarly, focusing only on physicians may lead to a lack of patient involvement in decision-making and may not address the emotional and psychological aspects of care. C: Family-focused - While involving families in care is important, solely focusing on them may not always align with the patient's best interests and may not address the patient's autonomy and individual needs.