A nurse at a primary care clinic is assessing a client for manifestations of depression. Which of the following client statements should the nurse identify as being consistent with depression?
"I can't sit still. I feel like I need to be doing things around the house."
"Lately, I feel like I am more alert than usual and can focus better."
"When I went to my provider, they told me I have high blood pressure."
"I can't get my mind to stop racing at night. I'm only sleeping a couple of hours.”
The Correct Answer is D
Rationale:
A. Feeling restless and needing to be active can be more indicative of anxiety or agitation rather than depression.
B. Increased alertness and improved focus are not typical symptoms of depression; rather, depression often involves decreased energy and focus.
C. High blood pressure is not directly related to depressive symptoms.
D. Difficulty sleeping and racing thoughts at night are consistent with depression, particularly when accompanied by poor sleep quality.
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Correct Answer is B
Explanation
Rationale:
A. Removing the PICC line should only be done if directed by a provider after further assessment.
B. The first action is to measure the circumference of both arms to assess for possible complications such as thrombosis or infiltration. This measurement will help determine the extent of the swelling and inform subsequent actions.
C. Notifying the provider is important but should be done after gathering relevant assessment data, such as the arm circumference.
D. Applying a cold pack may be appropriate for reducing swelling but is not the first step. Assessment should come first.
Correct Answer is A
Explanation
Rationale:
A. Sore throat and muscle aches are common symptoms of agranulocytosis, a serious side effect of clozapine, indicating a potentially dangerous drop in white blood cells.
B. Severe restlessness is not a primary indicator of agranulocytosis but could be related to other side effects or symptoms.
C. Increased anxiety and suicidal ideations are not specific symptoms of agranulocytosis but can be related to psychiatric conditions or medication effects.
D. Respiratory depression and a comatose state are not typical signs of agranulocytosis and would indicate a more severe, different medical emergency.