Nokea
Which of the following statements should the nurse use to best describe a very low-calorie diet (VLCD) to a client?
- A. This diet can be used when there is close medical supervision.'
- B. This is a long-term treatment measure that assists obese people who can't lose weight.'
- C. The VLCD consists of solid food items that are pureed to facilitate digestion and absorption.'
- D. A VLCD contains very little protein.'
Correct Answer: A
Rationale: VLCDs are used in the clinical treatment of obesity under close medical supervision. The diet is low in calories, high in quality protein, and has a minimum of carbohydrates to spare protein and prevent ketosis.
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A client has been taking alprazolam (Xanax) for four years to manage anxiety. The client reports taking 0.5 mg four times a day. Which statement indicates that the client understands the nurse's teaching about discontinuing the medication?
- A. I can drink alcohol now that I am decreasing my Xanax.
- B. I should not take another Xanax pill. Here is what is left of my last prescription.
- C. I should take three pills per day next week, then two pills for one week, then one pill for one week.
- D. I should expect to be sleepy for several days after stopping the medicine.
Correct Answer: C
Rationale: Xanax, like other benzodiazepines, can cause withdrawal symptoms that include agitation, insomnia, hypertension, seizures, and abdominal pain. The drug must be slowly decreased to prevent withdrawal symptoms.
The best definition of communication is:
- A. the sending and receiving of messages.
- B. the effect of sending verbal messages.
- C. an ongoing, interactive form of transmitting transactions.
- D. the use of message variables to send information.
Correct Answer: C
Rationale: Communication is a personal, interactive system—a series of ever-changing, ongoing transactions in the environment.
A nurse observes a client sitting alone and talking. When asked, the client reports that he is 'talking to the voices.' The nurse's next action should be:
- A. touching the client to help him return to reality
- B. leaving the client alone until reality returns
- C. asking the client to describe what is happening
- D. telling the client there are no voices
Correct Answer: C
Rationale: Asking the client to describe the hallucinations validates their experience and provides insight into their condition, aiding therapeutic communication. Touching may be intrusive, leaving them alone is non-therapeutic, and denying the voices dismisses their reality.
A nurse is teaching a group of clients with a diagnosis of Schizophrenia who are nearing discharge from a residential care facility. An essential topic to include is:
- A. pathophysiology of the disease and expected symptoms.
- B. how to recognize and manage symptoms of relapse.
- C. the need to take extra medication when feeling stressed.
- D. the importance of contact with follow-up care daily.
Correct Answer: B
Rationale: Clients are usually aware of the symptoms that indicate relapse is occurring. The client needs to know how to find a safe environment and to seek help. The first two stages of relapse are more difficult to recognize because they do not present symptoms that indicate psychosis. Initially, the client feels anxious and overwhelmed, and might become withdrawn. This is the crucial period to intervene. The client needs to go to a safe environment with someone who is trusted, avoid negative people, and decrease stimuli and stress.
When discussing the patterns of use of alcohol and other drugs, the nurse should include which piece of information?
- A. Lifetime prevalence and intensity of alcohol use is greater in women than men
- B. Hispanics and African Americans have higher levels of alcohol use than Caucasians
- C. Overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age
- D. Heavy use is more common in higher socioeconomic groups because they can afford to buy the drugs
Correct Answer: C
Rationale: Alcohol and drug use peaks in the mid-20s and decreases with age. Men have higher prevalence, Caucasians report more alcohol use, and heavy use is more common among less educated or unemployed groups.