A nurse provides instructions to a client taking fluoxetine (Prozac), an SSRI antidepressant. The nurse tells the client to take the medication:

Correct Answer: A

Rationale: The correct answer is A) Early in the morning. Fluoxetine (Prozac), as an SSRI antidepressant, is known to have stimulating effects, which can potentially cause insomnia if taken later in the day. By taking it early in the morning, the client can capitalize on these stimulating effects while minimizing the risk of sleep disturbances. Option B) During lunch time may not be the best choice because taking fluoxetine later in the day can disrupt sleep patterns due to its stimulating properties. Option C) At snack time is not recommended as it does not specify a specific time of day, and timing is crucial for medication effectiveness. Option D) At bedtime is incorrect because of the potential for insomnia if the medication is taken too late in the day. In an educational context, it is essential for nurses to understand the pharmacological effects of psychotropic medications to provide accurate and safe instructions to clients. Timing of medication administration is crucial to ensure optimal therapeutic benefits and minimize potential side effects. Nurses play a key role in medication education, emphasizing the importance of adherence to prescribed schedules for improved treatment outcomes in clients.

Correct Answer: D

Rationale: In the context of administering methylphenidate (Ritalin) to an 8-year-old child for ADHD treatment, monitoring height and weight is crucial. The correct answer, option D, is essential because stimulant medications like methylphenidate can potentially affect a child's growth and appetite. Regular monitoring of height and weight helps healthcare providers assess the medication's impact on the child's physical development and overall health. Option A, deep tendon reflex, is not typically monitored during psychotropic medication therapy for ADHD. This assessment is more relevant in neurological exams or when evaluating certain conditions like spinal cord injuries. Option B, intake and output, focuses on fluid balance and is important in conditions like kidney disease or heart failure where fluid management is critical. In the context of ADHD medication monitoring, it is not a primary concern. Option C, monitoring temperature and breath sounds, is more relevant in assessing respiratory or infectious conditions. While it is important in general patient care, it is not directly related to monitoring the effects of psychotropic medications like methylphenidate for ADHD. Educationally, understanding the rationale behind monitoring height and weight in children receiving ADHD medication is crucial for healthcare providers and nurses. It emphasizes the importance of comprehensive care and regular assessments to ensure the medication's effectiveness while monitoring potential side effects on growth and nutrition. This knowledge enhances patient safety and quality of care in pediatric psychopharmacology.

Correct Answer: A

Rationale: In this scenario, the appropriate nursing diagnosis for a client with schizophrenia receiving antipsychotic medication is "Ineffective protection related to blood dyscrasias" (Option A). Rationale for Option A (Correct Answer): - Antipsychotic medications can lead to blood dyscrasias, such as agranulocytosis or leukopenia, which compromise the body's ability to fight infections. This places the client at risk for potential harm due to decreased immune response. Therefore, monitoring for signs of blood dyscrasias and implementing measures to protect the client from infections is crucial. Rationale for Incorrect Options: - Option B (Urinary frequency related to adverse effects of antipsychotic medication): While antipsychotic medications can cause side effects like urinary frequency, this is not a priority nursing diagnosis compared to the risk of blood dyscrasias. - Option C (Risk for injury related to a severely decreased level of consciousness): This option is not directly associated with the side effects of antipsychotic medications; it may be relevant to other conditions but not specific to this client's situation. - Option D (Risk for injury related to electrolyte disturbances): While antipsychotic medications can sometimes lead to electrolyte imbalances, the risk of blood dyscrasias is a more immediate concern and takes precedence in this case. Educational Context: Understanding the potential side effects of psychotropic medications and their implications for nursing care is crucial in providing safe and effective care to clients with mental health disorders. By prioritizing nursing diagnoses based on the client's specific needs and the effects of their medication regimen, nurses can implement appropriate interventions to ensure client safety and well-being.

Correct Answer: B

Rationale: The correct answer is B: These side effects can be lessened with practical steps, such as sipping water, increasing dietary fiber, and moving more slowly when standing. Explanation: Dry mouth, constipation, and orthostatic hypotension (lightheadedness when standing) are common side effects of desipramine, a tricyclic antidepressant. These side effects are due to the medication's anticholinergic properties and its effects on blood pressure regulation. Practical steps like sipping water to alleviate dry mouth, increasing dietary fiber to manage constipation, and moving slowly when standing to prevent dizziness can help mitigate these side effects without discontinuing the medication. Why others are wrong: A) These symptoms are likely side effects of the medication, not the underlying disorder. Discontinuing the medication based on this assumption could lead to improper treatment. C) While these side effects can be uncomfortable, they are not indicative of a serious problem that requires immediate cessation of medication. D) Positive effects of desipramine may take weeks to manifest, and side effects may persist initially before potentially subsiding with continued use. Immediate resolution of side effects should not be expected. Educational context: Understanding the common side effects of psychotropic medications is crucial for healthcare providers and patients to manage treatment effectively. Educating patients on practical strategies to address these side effects can improve medication adherence and overall treatment outcomes. Monitoring for and addressing side effects early can enhance patient comfort and safety during psychotropic medication therapy.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) The antihistamine diphenhydramine. Diphenhydramine is an antihistamine commonly used as a sleep aid due to its sedative effects. In the context of a client scheduled for sleep studies, taking diphenhydramine can interfere with the results by artificially inducing sedation and altering the sleep patterns that need to be assessed during the study. A) The thyroid medication levothyroxine does not have a direct impact on sleep patterns and would not interfere with sleep studies. B) The loop diuretic furosemide is a diuretic and would not affect the sleep study results directly. D) The ACE inhibitor captopril is an antihypertensive medication and does not have sedative effects that would impact sleep patterns during the study. Educationally, understanding the effects of different medications on sleep patterns and the importance of accurate sleep study results is crucial for healthcare professionals working with clients experiencing sleep disturbances. It is essential to be aware of which medications can alter sleep architecture and interfere with diagnostic tests like sleep studies to provide optimal care and accurate assessment for clients with sleep disorders.