A patient says, “I have taken mega doses of vitamins for 3 months to improve my circulation, but I think I feel worse.” Which action should the nurse take first?

Correct Answer: B

Rationale: The correct answer is B. First, assess for symptoms and signs of toxicity from excess vitamin exposure because the patient mentioned feeling worse after taking mega doses of vitamins. This step is crucial to ensure patient safety. Option A is incorrect as simply advising caution without assessing for toxicity may delay necessary interventions. Option C is incorrect as assessing for circulatory integrity is not the immediate priority. Option D is also incorrect as educating the patient about research findings is important but not the immediate action needed in this situation.

Correct Answer: C

Rationale: Rationale for correct answer (C): St. John’s wort is commonly used to treat mild depressive symptoms due to its potential antidepressant effects. It may help improve mood and alleviate symptoms in individuals with mild depression. Summary of incorrect choices: A (mood swings): St. John’s wort is not typically recommended for mood swings as it is more targeted towards depressive symptoms. B (hypomanic symptoms): St. John’s wort can potentially worsen symptoms of mania or hypomania in individuals with bipolar disorder. D (panic disorder with agoraphobia): St. John’s wort is not indicated for treating panic disorder or agoraphobia as it may not effectively target the underlying causes of these conditions.

Correct Answer: B

Rationale: The correct step in Dell'Osso et al.'s framework is Medication education (B). This step involves providing patients with comprehensive information about their medications, including purpose, dosage, side effects, and importance of adherence. It is crucial in promoting understanding and acceptance of the prescribed treatment. Diagnosis (A) is not a step in the adherence framework but rather identifies the patient's condition. Monitoring plan (C) involves tracking adherence but is not the step being defined. Adherence reinforcement (D) comes after education and refers to strategies to maintain adherence, making it incorrect in this context.

Correct Answer: A

Rationale: The correct answer is A: Frontal lobe. Asterogenesis is the inability to recognize familiar objects by touch. Damage to the frontal lobe can disrupt sensory integration and impair perception. The frontal lobe is responsible for higher cognitive functions, including problem-solving, judgment, and decision-making. Damage to the temporal, parietal, or occipital lobes would not directly affect tactile object recognition.

Correct Answer: C

Rationale: The correct answer is C: The dosage should not exceed ½ of the usual recommended dose. Vortioxetine is primarily metabolized by the CYP2D6 enzyme. In poor 2D6 metabolizers, the metabolism of vortioxetine is significantly reduced, leading to higher drug levels in the body. Therefore, to prevent potential adverse effects or toxicity, the dosage should be reduced to avoid exceeding the usual recommended dose. A: The dosage of the drug will need to be increased - Incorrect. Due to reduced metabolism in poor 2D6 metabolizers, increasing the dosage would lead to higher drug levels and increased risk of adverse effects. B: The dosage needs to begin at half then increase over a 2-week period - Incorrect. Starting at half the dose is not sufficient for poor metabolizers as they may still experience increased drug levels. D: An adjunct medication will need to be prescribed until the dosage can be reduced - Incorrect. Adding another medication is not necessary