NU334 Exam 2 Guide With
Complete Solution
The nurse assigns a client with obsessive compulsive disorder a nursing
diagnosis of "ineffective impulse control" related to recurrent thoughts and
demonstrated by constant hand washing with hand wipes. Nursing
interventions will be aimed at: - ANSWER Helping patient maintain anxiety at
a manageable level in order to reduce the need for ritualistic behavior
A female client who is at high risk for suicide needs close supervision. To best
ensure the client's safety, the nurse will: - ANSWER Check the client
frequently at irregular intervals throughout the day
A newly admitted client who is diagnosed with major depressive disorder
isolates herself in her room and stares out the window. Which nursing
intervention would be the most appropriate to implement when first
establishing a nurse client relationship? - ANSWER Sit with client and offer
support frequently. Provide positive feedback on accomplishments achieved.
A depressed client is on reglan a common antiemetic which is known to
interact with SSSRIs and increase the risk of serotonin syndrome. The
prescribing provider orders paxil anyway. - ANSWER Constipation
A newly admitted client is experiencing a manic episode. He is pacing and
has extreme psychomotor agitation. The client's nursing dx is imbalance
nutrition, less than body req. Which meal is most appropriate for this client? -
ANSWER sandwich, granola bar, carrot stick,
A client with bipolar disorder is prescribed lamictal a mood stabilizer. What
, statement by the patient indicates an understanding of proper measures to
be taken with lamictal. - ANSWER I should call my doctor if I have a rash.
A 17-year-old female client is brought to an inpatient psychiatric unit by her
parents. She has been given a provisional dx of Major Depressive Disorder.
Which assessment finding best indicates that she is experiencing a depressive
disorder? - ANSWER parents state that she is no longer enjoys cheer practice
and states she feels sad all the time for more than 2 weeks
A client is admitted to the behavioral health unit with a diagnosis of major
depression (MAOI) - ANSWER red wine
A male diagnosed with schizophrenia denies any homicidal or suicidal
ideations. He has no history of violent behaviors. His voices are telling him
that he is a kind and benevolent king and master. He states that all he wants
to do is "sit on his golden throne" pointing to the chair in his room. Based
upon this data and history, what might be the nurses primary diagnosis: -
ANSWER Disturbed thought processes as evidenced by auditory
hallucinations, illusions, and delusions.
A newly admitted client is dx'd with anxiety disorder. Which short term
outcome is appropriate? - ANSWER The client will rate anxiety as 3 out of 10
by day 4 of admission
A client is newly diagnosed with obsessive compulsive disorder and spends
45 minutes folding and rearranging them in drawers. Which nursing
intervention would best address this clients problem? - ANSWER Discuss the
anxiety-provoking triggers that precipitate the ritualistic behaviors
How would a nurse differentiate a client diagnosed with panic disorder from
a client diagnosed with generalized anxiety disorder (GAD)? - ANSWER
Complete Solution
The nurse assigns a client with obsessive compulsive disorder a nursing
diagnosis of "ineffective impulse control" related to recurrent thoughts and
demonstrated by constant hand washing with hand wipes. Nursing
interventions will be aimed at: - ANSWER Helping patient maintain anxiety at
a manageable level in order to reduce the need for ritualistic behavior
A female client who is at high risk for suicide needs close supervision. To best
ensure the client's safety, the nurse will: - ANSWER Check the client
frequently at irregular intervals throughout the day
A newly admitted client who is diagnosed with major depressive disorder
isolates herself in her room and stares out the window. Which nursing
intervention would be the most appropriate to implement when first
establishing a nurse client relationship? - ANSWER Sit with client and offer
support frequently. Provide positive feedback on accomplishments achieved.
A depressed client is on reglan a common antiemetic which is known to
interact with SSSRIs and increase the risk of serotonin syndrome. The
prescribing provider orders paxil anyway. - ANSWER Constipation
A newly admitted client is experiencing a manic episode. He is pacing and
has extreme psychomotor agitation. The client's nursing dx is imbalance
nutrition, less than body req. Which meal is most appropriate for this client? -
ANSWER sandwich, granola bar, carrot stick,
A client with bipolar disorder is prescribed lamictal a mood stabilizer. What
, statement by the patient indicates an understanding of proper measures to
be taken with lamictal. - ANSWER I should call my doctor if I have a rash.
A 17-year-old female client is brought to an inpatient psychiatric unit by her
parents. She has been given a provisional dx of Major Depressive Disorder.
Which assessment finding best indicates that she is experiencing a depressive
disorder? - ANSWER parents state that she is no longer enjoys cheer practice
and states she feels sad all the time for more than 2 weeks
A client is admitted to the behavioral health unit with a diagnosis of major
depression (MAOI) - ANSWER red wine
A male diagnosed with schizophrenia denies any homicidal or suicidal
ideations. He has no history of violent behaviors. His voices are telling him
that he is a kind and benevolent king and master. He states that all he wants
to do is "sit on his golden throne" pointing to the chair in his room. Based
upon this data and history, what might be the nurses primary diagnosis: -
ANSWER Disturbed thought processes as evidenced by auditory
hallucinations, illusions, and delusions.
A newly admitted client is dx'd with anxiety disorder. Which short term
outcome is appropriate? - ANSWER The client will rate anxiety as 3 out of 10
by day 4 of admission
A client is newly diagnosed with obsessive compulsive disorder and spends
45 minutes folding and rearranging them in drawers. Which nursing
intervention would best address this clients problem? - ANSWER Discuss the
anxiety-provoking triggers that precipitate the ritualistic behaviors
How would a nurse differentiate a client diagnosed with panic disorder from
a client diagnosed with generalized anxiety disorder (GAD)? - ANSWER
