Nurse T admit Ms. S. Priority action for T to
take? - - Assess respiratory status
Nurse T is communicating with Ms. S. Which is
an appropriate action for T to take? - -
Nurse T assess Ms. S. Which assessment scales Restate Ms. S's concern
is appropriate? - - Hamilton-A
Nurse T is listening to Ms. S while she describes
Nurse T completes the Hamilton-A assessment the stressors that contribute to her anxiety. Which
of Ms. S and determines her score to be 26. coping mechanisms is Ms. S. exhibiting? - -
Which appropriate action for the nurse to take? - Denial
- Lorazepam Displacement
Rationalizing
Nurse T preparing to call provider. List the
findings. - - S (Situation) = Ms. Simpson is Nurse T is discussing Ms. S is most stressful
a 22-year-old African-American female admitted situation. Which actions should T take first? -
to the inpatient mental health unit for anxiety. - Continue to gather more information
She is restless and fidgety, has poor regarding finances
concentration, and has been experiencing chest
pain and shortness of breath.
B (Background) = She has a history of Nurse T has discovered Ms. S self-injury. Which
generalized anxiety disorder and has previously thought processes is most likely a reflection of
taken paroxetine 20 mg PO daily, but has not Ms. S behavior? - - Alleviation of
been taking it for approximately 2 weeks. psychological pain
A (Assessment)= Her vital signs from report at
0745 were: heart rate 115, blood pressure
148/76, respirations 32, oxygen saturation 96% Nurse T is providing medication teaching
on room air, and temperature 37.0 C (98.6 F). regarding escitalopram. Which statements should
Her score on the Hamilton A scale is 26, and she T include in the teaching? - - You should
has been unable to focus on answering report increased thoughts of suicide.
questions due to her severe level of anxiety. She
continues to pace, wring her hands, and rock
when sitting. Nurse T is explaining Ms. S diagnosis. Which
R (Recommendation) = I am calling to request a statements should T include in the teaching? -
prescription for lorazepam. - Interventions are based on the degree of
anxiety you are experiencing.
Nurse T is calculating the dose of lorazepam. You can experience four levels of anxiety.
Available 4mg/mL. How many mL should the
nurse admin? - - 0.5 It is common to perform repetitive behaviors in
order to cope with anxiety.
Nurse T is initiating therapeutic communication
with Ms. S. Which video best? - - Video 3 Nurse T is teaching Ms. S about anxiety. Which
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