NR 326 CMS Exam with correct answers ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
What is Nurse John likely to note in a male client being admitted for alcohol withdrawal?
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. Perceptual disorders
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B. Impending coma
||\\||\\ ||\\||\\
C. Recent alcohol intake
||\\||\\ ||\\||\\ ||\\||\\
D. Depression with mutism
||\\||\\ ||\\||\\ ||\\||\\
Option A: Frightening visual hallucinations are especially common in clients experiencing alcohol withdrawal
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
June has agreed to take amitriptyline HCL (Elavil) for 3 days, but now complains that it “doesn’t help”
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
and refuses to take it. What should the nurse say or do?
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. Withhold the drug
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B. Record the client’s response
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Encourage client to tell the physician
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. Suggest that it takes awhile before seeing the results.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Option D: The client needs a specific response; that it takes 2 to 3 weeks (a delayed effect) until the
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
therapeutic blood level is reached. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
In preparing a female client for electroconvulsive therapy (ECT), Nurse Michelle knows that succinylcholine
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
(Anectine) will be administered for which therapeutic effect?
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. Short acting anesthesia
||\\||\\ ||\\||\\ ||\\||\\
B. Decreased oral and respiratory secretions
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Skeletal muscle paralysis
||\\||\\ ||\\||\\ ||\\||\\
D. Analgesia ||\\||\\
Option C: Succinylcholine (Anectine)is a depolarizing muscle relaxant causing paralysis. It is used to reduce
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the intensity of muscle contractions during the convulsive stage, thereby reducing the risk of bone fractures
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
or dislocation
||\\||\\
Nurse Gina is aware that the dietary implications for a client in manic phase of bipolar disorder is:
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. Serve the client a bowl of soup
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
B. Increase calories, decrease fat, and decrease carbohydrates
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Give the client pieces of cut up steak, potatoes, peas
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. Increase calories, increase carbohydrates, and increase protein
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Option D: This client needs increased protein for tissue building and increased calories to replace what is
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
burned up (usually via carbohydrates); preferable, portable d/t acute mania sx
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Potatoes- does not indicate if portable ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
,What parental behavior toward a child during an admission procedure should cause Nurse Ron to suspect
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
child abuse?
||\\||\\ ||\\||\\
A. Flat affect
||\\||\\ ||\\||\\
B. Expressing guilt
||\\||\\ ||\\||\\
C. Acting overly solicitous toward the child
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. Ignoring the child
||\\||\\ ||\\||\\ ||\\||\\
Option C: Acting overly solicitous (overly concerned, mindful, anxiously concerned) toward the child
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
This behavior is an example of reaction formation, a coping mechanism.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Nurse Lynnette notices that a female client with obsessive-compulsive disorder washes her hands for long
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
periods each day. How should the nurse respond to this compulsive behavior?
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. By designating times during which the client can focus on the behavior
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
B. By urging the client to reduce the frequency of the behavior as rapidly as possible
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. By calling attention to, or attempting to prevent the behavior
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. By discouraging the client from verbalizing anxieties
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CORRECT - Option A: The nurse should designate times during which the client can focus on the compulsive
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
behavior or obsessive thoughts. ||\\||\\ ||\\||\\ ||\\||\\
Option B: The nurse should urge the client to reduce the frequency of the compulsive behavior gradually,
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
not rapidly. ||\\||\\
Option C: She shouldn’t call attention to, or try to prevent the behavior. Trying to prevent the behavior may
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
cause pain and terror to the client.
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Option D: The nurse should encourage the client to verbalize anxieties to help distract attention from the
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compulsive behavior. ||\\||\\
After seeking help at an outpatient mental health clinic, Ruby, who was raped while walking her dog, is
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
diagnosed with posttraumatic stress disorder (PTSD). Three months later, Ruby returns to the clinic,
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
for Ruby? ||\\||\\
A. Recommending a high protein, low-fat diet
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
B. Giving sleep medication, as prescribed, to restore a normal sleep-wake cycle
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Allowing the client time to heal
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. Exploring the meaning of the traumatic event with the client
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
CORRECT - Option D: The client with PTSD needs encouragement to examine and understand the meaning
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
of the traumatic event and consequent losses. Otherwise, symptoms may worsen and the client may become
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
depressed or engage in self-destructive behavior such as substance abuse.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Option A: A special diet isn’t indicated unless the client also has an eating disorder or a nutritional problem.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Option B: The physician may prescribe antianxiety agents or antidepressants cautiously to avoid dependence;
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
sleep medication is rarely appropriate. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
, Option C: The client must explore the meaning of the event and won’t heal without this, no matter how
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
much time passes. Behavioral techniques, such as relaxation therapy, may help decrease the client’s anxiety
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
and induce sleep. Exposure therapy may also be indicated.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Meryl, age 19, is highly dependent on her parents and fears leaving home to go away to college. Shortly
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
before the semester starts, she complains that her legs are paralyzed and is rushed to the emergency
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department. When physical examination rules out a physical cause for her paralysis, the physician admits ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
her to the psychiatric unit where she is diagnosed with conversion disorder. Meryl asks the nurse, “Why
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has this happened to me?” What is the nurse’s best response?
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. “You’ve developed this paralysis so you can stay with your parents. You must deal with the conflict if you
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
want to walk again.”
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B. “It must be awful not to be able to move your legs. You may feel better if you realize the problem is
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psychological, not physical.” ||\\||\\ ||\\||\\
C. “Your problem is real but there is no physical basis for it. We’ll work on what is going on in your life and
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why it’s happened.”
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D. “It isn’t uncommon for someone with your personality to develop a conversion disorder during times of
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stress.”
CORRECT - Option C: The nurse must be honest with the client by telling her that the paralysis has no
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
physiologic cause while also conveying empathy and acknowledging that her symptoms are real. The client ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
will benefit from psychiatric treatment, which will help her understand the underlying cause of her
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symptoms. After the psychological conflict is resolved, her symptoms will disappear. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Option A: Telling her that she has developed paralysis to avoid leaving her parents or that her personality
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
caused her disorder wouldn’t help her understand and resolve the underlying conflict.
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Option B: Saying that it must be awful not to be able to move her legs wouldn’t answer the client’s
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question; knowing that the cause is psychological wouldn’t necessarily make her feel better. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Nurse Trina knows that the following drugs have been known to be effective in treating obsessive-
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
compulsive disorder (OCD): ||\\||\\ ||\\||\\
A. Benztropine (Cogentin) and diphenhydramine (Benadryl)
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
B. Chlordiazepoxide (Librium) and Diazepam (Valium)
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Fluvoxamine (Luvox) and Clomipramine (Anafril)
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. Divalproex (Depakote) and Lithium (Lithobid)
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
CORRECT - Option C: The antidepressants fluvoxamine and clomipramine have been effective in the||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
treatment of OCD. ||\\||\\ ||\\||\\
Option B: Librium and Valium may be helpful in treating anxiety related to OCD but aren’t drugs of choice to
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
treat the illness.
||\\||\\ ||\\||\\ ||\\||\\
Options A and D: The other medications mentioned aren’t effective in the treatment of OCD.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone (BuSpar). The nurse
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
is aware that the teaching instructions for newly prescribed buspirone should include which of the
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
following?
A. A warning about the drug’s delayed therapeutic effect, which is from 14-30 days
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
What is Nurse John likely to note in a male client being admitted for alcohol withdrawal?
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. Perceptual disorders
||\\||\\ ||\\||\\
B. Impending coma
||\\||\\ ||\\||\\
C. Recent alcohol intake
||\\||\\ ||\\||\\ ||\\||\\
D. Depression with mutism
||\\||\\ ||\\||\\ ||\\||\\
Option A: Frightening visual hallucinations are especially common in clients experiencing alcohol withdrawal
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
June has agreed to take amitriptyline HCL (Elavil) for 3 days, but now complains that it “doesn’t help”
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
and refuses to take it. What should the nurse say or do?
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. Withhold the drug
||\\||\\ ||\\||\\ ||\\||\\
B. Record the client’s response
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Encourage client to tell the physician
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. Suggest that it takes awhile before seeing the results.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Option D: The client needs a specific response; that it takes 2 to 3 weeks (a delayed effect) until the
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
therapeutic blood level is reached. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
In preparing a female client for electroconvulsive therapy (ECT), Nurse Michelle knows that succinylcholine
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
(Anectine) will be administered for which therapeutic effect?
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. Short acting anesthesia
||\\||\\ ||\\||\\ ||\\||\\
B. Decreased oral and respiratory secretions
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Skeletal muscle paralysis
||\\||\\ ||\\||\\ ||\\||\\
D. Analgesia ||\\||\\
Option C: Succinylcholine (Anectine)is a depolarizing muscle relaxant causing paralysis. It is used to reduce
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
the intensity of muscle contractions during the convulsive stage, thereby reducing the risk of bone fractures
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
or dislocation
||\\||\\
Nurse Gina is aware that the dietary implications for a client in manic phase of bipolar disorder is:
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A. Serve the client a bowl of soup
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
B. Increase calories, decrease fat, and decrease carbohydrates
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
C. Give the client pieces of cut up steak, potatoes, peas
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. Increase calories, increase carbohydrates, and increase protein
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Option D: This client needs increased protein for tissue building and increased calories to replace what is
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
burned up (usually via carbohydrates); preferable, portable d/t acute mania sx
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Potatoes- does not indicate if portable ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
,What parental behavior toward a child during an admission procedure should cause Nurse Ron to suspect
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
child abuse?
||\\||\\ ||\\||\\
A. Flat affect
||\\||\\ ||\\||\\
B. Expressing guilt
||\\||\\ ||\\||\\
C. Acting overly solicitous toward the child
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
D. Ignoring the child
||\\||\\ ||\\||\\ ||\\||\\
Option C: Acting overly solicitous (overly concerned, mindful, anxiously concerned) toward the child
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
This behavior is an example of reaction formation, a coping mechanism.
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Nurse Lynnette notices that a female client with obsessive-compulsive disorder washes her hands for long
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periods each day. How should the nurse respond to this compulsive behavior?
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A. By designating times during which the client can focus on the behavior
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B. By urging the client to reduce the frequency of the behavior as rapidly as possible
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C. By calling attention to, or attempting to prevent the behavior
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D. By discouraging the client from verbalizing anxieties
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CORRECT - Option A: The nurse should designate times during which the client can focus on the compulsive
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behavior or obsessive thoughts. ||\\||\\ ||\\||\\ ||\\||\\
Option B: The nurse should urge the client to reduce the frequency of the compulsive behavior gradually,
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not rapidly. ||\\||\\
Option C: She shouldn’t call attention to, or try to prevent the behavior. Trying to prevent the behavior may
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cause pain and terror to the client.
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Option D: The nurse should encourage the client to verbalize anxieties to help distract attention from the
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compulsive behavior. ||\\||\\
After seeking help at an outpatient mental health clinic, Ruby, who was raped while walking her dog, is
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diagnosed with posttraumatic stress disorder (PTSD). Three months later, Ruby returns to the clinic,
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complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
for Ruby? ||\\||\\
A. Recommending a high protein, low-fat diet
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B. Giving sleep medication, as prescribed, to restore a normal sleep-wake cycle
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C. Allowing the client time to heal
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D. Exploring the meaning of the traumatic event with the client
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CORRECT - Option D: The client with PTSD needs encouragement to examine and understand the meaning
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of the traumatic event and consequent losses. Otherwise, symptoms may worsen and the client may become
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depressed or engage in self-destructive behavior such as substance abuse.
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Option A: A special diet isn’t indicated unless the client also has an eating disorder or a nutritional problem.
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Option B: The physician may prescribe antianxiety agents or antidepressants cautiously to avoid dependence;
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sleep medication is rarely appropriate. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
, Option C: The client must explore the meaning of the event and won’t heal without this, no matter how
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much time passes. Behavioral techniques, such as relaxation therapy, may help decrease the client’s anxiety
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and induce sleep. Exposure therapy may also be indicated.
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Meryl, age 19, is highly dependent on her parents and fears leaving home to go away to college. Shortly
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before the semester starts, she complains that her legs are paralyzed and is rushed to the emergency
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department. When physical examination rules out a physical cause for her paralysis, the physician admits ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
her to the psychiatric unit where she is diagnosed with conversion disorder. Meryl asks the nurse, “Why
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has this happened to me?” What is the nurse’s best response?
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A. “You’ve developed this paralysis so you can stay with your parents. You must deal with the conflict if you
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want to walk again.”
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B. “It must be awful not to be able to move your legs. You may feel better if you realize the problem is
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psychological, not physical.” ||\\||\\ ||\\||\\
C. “Your problem is real but there is no physical basis for it. We’ll work on what is going on in your life and
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why it’s happened.”
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D. “It isn’t uncommon for someone with your personality to develop a conversion disorder during times of
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stress.”
CORRECT - Option C: The nurse must be honest with the client by telling her that the paralysis has no
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physiologic cause while also conveying empathy and acknowledging that her symptoms are real. The client ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
will benefit from psychiatric treatment, which will help her understand the underlying cause of her
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symptoms. After the psychological conflict is resolved, her symptoms will disappear. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Option A: Telling her that she has developed paralysis to avoid leaving her parents or that her personality
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caused her disorder wouldn’t help her understand and resolve the underlying conflict.
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Option B: Saying that it must be awful not to be able to move her legs wouldn’t answer the client’s
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question; knowing that the cause is psychological wouldn’t necessarily make her feel better. ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Nurse Trina knows that the following drugs have been known to be effective in treating obsessive-
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compulsive disorder (OCD): ||\\||\\ ||\\||\\
A. Benztropine (Cogentin) and diphenhydramine (Benadryl)
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B. Chlordiazepoxide (Librium) and Diazepam (Valium)
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C. Fluvoxamine (Luvox) and Clomipramine (Anafril)
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D. Divalproex (Depakote) and Lithium (Lithobid)
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CORRECT - Option C: The antidepressants fluvoxamine and clomipramine have been effective in the||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
treatment of OCD. ||\\||\\ ||\\||\\
Option B: Librium and Valium may be helpful in treating anxiety related to OCD but aren’t drugs of choice to
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treat the illness.
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Options A and D: The other medications mentioned aren’t effective in the treatment of OCD.
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Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone (BuSpar). The nurse
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is aware that the teaching instructions for newly prescribed buspirone should include which of the
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following?
A. A warning about the drug’s delayed therapeutic effect, which is from 14-30 days
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