The occupational health nurse is working with a female employee who was just notified that her child was involved in a MVA and taken to the hospital. The employee states, 'I can't believe this. What should I do?' Which response is best for the RN to provide in this crisis?

Correct Answer: D

Rationale: The correct answer is D: Call for transportation to the hospital. This response is the best because it addresses the immediate need for the employee to be with her child at the hospital. Providing transportation shows support and helps the employee to take action quickly. A: Tell me what you think should happen - This response puts the onus on the employee to make a decision when she is in a crisis situation, which may not be the most helpful approach. B: How serious was the collision? - While showing concern, this response does not address the immediate need for the employee to be with her child at the hospital. C: What do you think you should do? - Similar to choice A, this response also shifts the responsibility to the employee and may not be the most supportive in a crisis.

Correct Answer: A

Rationale: The correct answer is A: Weight gain of 75 lbs. Olanzapine is known to cause significant weight gain as a common side effect. This is due to its impact on appetite control and metabolic processes. Other choices are less likely to be directly related to olanzapine. B, thoughts of wanting to hurt himself, is a serious side effect of olanzapine but not as common as weight gain. C, frequent days with diarrhea, is not a typical side effect of olanzapine. D, altered liver function tests, is a possible side effect of olanzapine but weight gain is more commonly associated with it.

Correct Answer: D

Rationale: The correct answer is D: Assess and report the client's electrolyte status to the healthcare provider. This is the highest priority because electrolyte imbalances are common in clients with bulimia nervosa due to purging behaviors. Monitoring electrolytes is crucial to prevent life-threatening complications. A: Scheduling group therapy may be beneficial, but addressing the physical health concern is the priority. B: Assigning care based on age is not essential in this situation. C: Monitoring for binging activities is important but not as critical as assessing electrolyte status. In summary, ensuring the client's physical health and safety by monitoring electrolyte status is the top priority in managing a client with bulimia nervosa.

Correct Answer: B

Rationale: The correct answer is B (2 to 4 weeks) because antidepressants typically take around 2 to 4 weeks to start showing noticeable effects. Initially, the medication needs time to build up in the system and adjust serotonin levels in the brain. It takes a few weeks for the neurotransmitter balance to stabilize and for the individual to experience improvements in mood and symptoms. Choice A (1 to 2 weeks) is too soon for significant effects to occur. Choice C (4 to 6 weeks) and D (6 to 8 weeks) are too long for the typical onset of action for most antidepressants.

Correct Answer: A

Rationale: The correct answer is A because encouraging the client to actively participate in assigned activities can help distract him from his paranoid thoughts and promote engagement in therapeutic interventions. This can also help establish a routine and promote socialization. B: Confronting the client may escalate his paranoia and lead to increased distress. C: Limiting interactions may further isolate the client and exacerbate his paranoia. D: Administering PRN medication should be considered if the client becomes agitated or poses a risk to himself or others, but it does not address the underlying issue of paranoia.