The patient has been receiving amitriptyline (Elavil) for 2 weeks. He tells the nurse he doesn't think this medicine is working, as he is still depressed. What is the best response by the nurse?

Correct Answer: A

Rationale: In this scenario, the best response by the nurse is option A) "It is working, but it can take several weeks to have an effect." This response is correct because amitriptyline, a tricyclic antidepressant, often takes 2-4 weeks to start showing its full therapeutic effects in treating depression. It is crucial for the nurse to educate the patient about the delayed onset of action for this medication to manage their expectations and encourage adherence to the treatment plan. Option B) "You might still feel depressed, but you are looking much better" is incorrect as it does not address the patient's concern about the medication's effectiveness and might give a false sense of improvement based solely on physical appearance. Option C) "This may not be the best medicine for you; I'll call your doctor" is incorrect because it undermines the treatment plan without giving it enough time to work. It is essential to allow an adequate trial period before considering changing medications. Option D) "It is working, but it can take several months to have an effect" is incorrect as it provides inaccurate information about the onset of action for amitriptyline, which typically ranges from weeks, not months. Educationally, this scenario highlights the importance of patient education, managing expectations regarding medication effects, and promoting adherence to treatment plans. Nurses play a crucial role in ensuring patients have accurate information about their medications to support their mental health and well-being.

Correct Answer: D

Rationale: In the context of safety pharmacology, it is crucial for nurses to educate clients about potential adverse effects of medications like diphenhydramine (Benadryl). The correct answer, option D - Urinary hesitancy, is the symptom the nurse should teach the client to report to the physician. This is because diphenhydramine is known to have anticholinergic effects, which can lead to urinary retention or hesitancy, especially in older adults. Option A - Sedation, is a common side effect of diphenhydramine but is generally well-tolerated and not typically a cause for immediate concern unless it is excessive or affects daily functioning. Option B - Diarrhea, is not a common side effect of diphenhydramine and would not be the priority symptom to report. Option C - Projectile vomiting, while a serious symptom, is not typically associated with diphenhydramine use. Educationally, this scenario highlights the importance of medication education, particularly focusing on common side effects and when to seek medical attention. Understanding the specific adverse effects of medications helps in promoting patient safety and effective management of symptoms. Nurses play a vital role in empowering clients to recognize and report concerning symptoms promptly to ensure timely intervention and prevent complications.

Correct Answer: A

Rationale: Rapid, alternating hand movements test cerebellar functioning, specifically coordination and fine motor control, as the cerebellum regulates these actions. Cognitive functioning involves memory and reasoning, reflex arcs assess nerve pathways, and stereognosis tests sensory recognition, none of which are directly evaluated by this task.

Correct Answer: B

Rationale: In this scenario, the correct test to order for the patient who had a total gastrectomy and is presenting with symptoms of a sore mouth, indigestion, and tingling in the lower extremities is a Complete Blood Count (CBC), which is option B. A CBC is a routine test that provides important information about the types and numbers of cells in the blood, including red blood cells, white blood cells, and platelets. In this case, the symptoms described by the patient could be indicative of potential nutritional deficiencies, such as anemia or vitamin deficiencies, which can be detected through abnormalities in the CBC results. Option A, a Blood Urea Nitrogen (BUN) level, is primarily used to assess kidney function and would not directly provide information related to the symptoms described by the patient. Option C, a Liver Function Study, is more focused on assessing liver health and would not be the most appropriate test given the patient's symptoms. Educationally, by understanding the rationale behind selecting a CBC in this case, healthcare providers can learn to correlate patient symptoms with appropriate diagnostic tests, enhancing their clinical reasoning skills and ability to provide effective patient care. It also highlights the importance of considering nutritional deficiencies in patients who have undergone procedures like a total gastrectomy.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Giving 'hot' foods to counteract a 'cold' illness. The Taoist philosophy of yin and yang emphasizes balance and harmony between opposing forces. In this context, 'hot' foods are believed to balance a 'cold' illness by restoring harmony in the body's energy. Option A, applying a heated glass to draw out infection, is a practice more aligned with traditional Chinese medicine than Taoist philosophy. Option B, burning incense to drive away evil spirits, pertains more to spiritual beliefs rather than balancing energies within the body. Option D, using an onion to eradicate a fever, lacks a direct connection to the principles of yin and yang or Taoist healing practices. Educationally, understanding cultural and philosophical beliefs related to health and healing is crucial for healthcare providers to deliver culturally competent care. By recognizing the influence of Taoist principles, healthcare professionals can better communicate with patients and families who adhere to these beliefs, ultimately enhancing patient outcomes and satisfaction.