Page 2378 - Saunders Comprehensive Review For NCLEX-RN

855. A client receiving tricyclic antidepressants arrives at the mental health clinic.
Which observation would indicate that the client is following the medication
plan correctly?
1. Client reports not going to work for the past week.
2. Client complains of not being able to “do anything” anymore.
3. Client arrives at the clinic neat and appropriate in appearance.
4. Client reports sleeping 12 hours per night and 3 to 4 hours during
the day.

Answers

842. Answer: 2

Rationale: Sertraline is classified as an antidepressant. Sertraline generally is
administered once every 24 hours. It may be administered in the morning or
evening, but evening administration may be preferable because drowsiness is a side
effect. The medication may be administered without food or with food if
gastrointestinal distress occurs. Sertraline is not prescribed for use as needed.
Test-Taking Strategy: Focus on the subject, administration of sertraline. Recalling
that this medication is an antidepressant administered daily will direct you to the
correct option.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Pharmacology: Psychotherapeutics: Selective Serotonin Reuptake
Inhibitors (SSRIs)
Health Problem: Mental Health: Mood Disorders
Priority Concepts: Mood and Affect; Safety
Reference: Burchum, Rosenthal (2016), pp. 346-347.

843. Answer: 4

Rationale: A client taking clozapine may experience agranulocytosis, which is
monitored by reviewing the results of the white blood cell count. Treatment is
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interrupted if the white blood cell count decreases to less than 3000 mm (3 × 10 /L).
Agranulocytosis could be fatal if undetected and untreated. The other laboratory
studies are not related specifically to the use of this medication.
Test-Taking Strategy: Focus on the subject, complications associated with
clozapine. It is necessary to recall that this medication causes agranulocytosis; this
will direct you to the correct option.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Pharmacology: Psychotherapeutic: Antipsychotics
Health Problem: Mental Health: Schizophrenia
Priority Concepts: Cellular Regulation; Psychosis

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