Correct Answer: D

Rationale: Monitoring for signs of serotonin syndrome (e.g., agitation, tremors, hyperthermia) is critical with fluoxetine, an SSRI, as it increases serotonin levels, and overdose or drug interactions can cause this life-threatening condition.
Choice A is incorrect because fluoxetine is typically taken in the morning, but this is not the priority instruction compared to safety monitoring.
Choice B is incorrect because fluoxetine takes 4-6 weeks to reduce OCD symptoms, not immediate relief.
Choice C is incorrect because fluoxetine should not be discontinued abruptly, even if compulsions stop, to avoid withdrawal or relapse; it requires provider guidance.

Correct Answer: A

Rationale: Applying a cold pack to the surgical site for the first 24 hours reduces swelling and pain, promoting comfort and recovery after total knee arthroplasty.
Choice B is incorrect because keeping the affected leg in a dependent position increases swelling; the leg should be elevated to reduce edema.
Choice C is incorrect because active range-of-motion exercises are typically started later (e.g., day 2 or 3), with passive or assisted exercises on day 1 to avoid strain.
Choice D is incorrect because heparin is usually given subcutaneously (e.g., enoxaparin) for DVT prophylaxis, not IV, and the duration depends on the provider's protocol, not automatically 7 days.

Correct Answer: A

Rationale: Taking omeprazole 30 minutes before breakfast optimizes its acid-suppressing effect by aligning with the body's natural acid production cycle, improving GERD symptom control.
Choice B is incorrect because omeprazole may take several days to provide significant relief, not immediate relief.
Choice C is incorrect because, while swallowing the capsule whole is correct for delayed-release formulations, the timing (before meals) is more critical to emphasize for efficacy.
Choice D is incorrect because taking omeprazole with an antacid is not recommended, as it may reduce the drug's effectiveness; antacids are used for immediate relief, not in combination with proton pump inhibitors.

Correct Answer: A

Rationale: This instruction will help the client to prevent venous stasis and thrombosis, which are common postoperative complications. Range-of-motion exercises promote blood circulation and prevent muscle atrophy and contractures.
Choice B is wrong because using an incentive spirometer every 4 hours is not related to promoting circulation, but rather to improving lung expansion and preventing atelectasis and pneumonia. Using an incentive spirometer is also important for postoperative clients, but it does not address the question.
Choice C is wrong because remaining on bed rest for 24 hours following the procedure is the opposite of promoting circulation. Bed rest increases the risk of venous stasis, thrombosis, and pulmonary embolism. Postoperative clients should be encouraged to ambulate as soon as possible, unless contraindicated.
Choice D is wrong because placing a pillow under your knees while in bed impairs circulation and increases the risk of thrombosis. Placing a pillow under the knees can cause pressure on the popliteal veins and reduce blood flow. Postoperative clients should avoid this position and keep their legs in a neutral or slightly elevated position.

Correct Answer: D

Rationale:
Choice A is wrong because flushing the catheter with saline should be done after securing the catheter to the skin with a transparent dressing and attaching a primed piece of extension tubing to the catheter.
Choice B is wrong because retracting the stylet should be done after advancing the catheter into the vein and releasing the tourniquet from the client's arm.
Choice C is wrong because releasing the tourniquet should be done after advancing the catheter into the vein and before retracting the stylet. This is because after puncturing the skin and the vein, the nurse needs to advance the catheter into the vein with the finger hub to ensure proper placement and prevent complications such as infiltration or phlebitis.