A client being treated for depression has been taking 300 mg amitriptyline (Elavil) daily for nearly a
year.
She calls her case manager at the mental health clinic, stating she stopped taking her
antidepressant 2 days ago and has developed something like the "flu," with cold sweats, nausea, a
rapid heartbeat, and terrible nightmares when she sleeps. The nurse should advise the client
a. to go to the nearest emergency department immediately.
b. not to be alarmed and to take two aspirin and drink plenty of fluids.
c. to take one dose of the tricyclic antidepressant and come to the clinic to see the
physician.
d. to resume taking the tricyclic antidepressant for 2 weeks and then discontinue
again.
C
The client has symptoms associated with abrupt withdrawal of the tricyclic antidepressant. Taking a
dose of the drug will ameliorate the symptoms. Seeing the physician will allow her to discuss the
advisability of going off the medication and to be given a gradual withdrawal schedule if
discontinuation is the decision. Option A: This situation is not a medical emergency. Option B: The
situation calls for medical advice. Option D would produce the same symptoms she currently has.
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To man\age resistance to change, the change agent may use which strategy?
1. Defend the status quo. 2. Provide evidence to challenge the status quo. 3. Reject opposition to the plan. 4. Eliminate from the organization those who are opposed.
The nurse caring for a patient with Cushing's syndrome is teaching the patient about the dexamethasone suppression test scheduled for tomorrow. What does the nurse explain that this test will involve?
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Ordered: nine 1,000 unit vials of insulin lispro; inject 38 units subcutaneously 4 times a day, with meals and at bedtime. How many days will this order last the patient?
A. 59 days B. 60 days C. 26 days D. 27 days
A patient has been received in the emergency department for treatment of poison ingestion. Gastric lavage and placement of activated charcoal has been prescribed. The nurse would withhold this treatment and collaborate with the prescriber if which instances occur? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply
1. The patient vomits. 2. The patient becomes unconscious. 3. The patient discloses that lithium was the drug taken. 4. Paramedics report that it has been 2 hours since the drug was taken. 5. The patient begins to pass copious amounts of watery diarrhea.