Nokea
The healthcare professional is developing a discharge plan for a client recovering from alcohol withdrawal. Which instruction should be included in the client's discharge teaching?
- A. Avoid all social situations involving alcohol.
- B. Continue taking prescribed medications.
- C. Contact a support group such as Alcoholics Anonymous.
- D. Avoid using any over-the-counter medications.
Correct Answer: C
Rationale: It is essential to include instructions for the client to contact a support group like Alcoholics Anonymous in their discharge teaching. Support groups play a vital role in providing ongoing support, guidance, and encouragement during the recovery process from alcohol withdrawal, helping to prevent relapse. Choice A is incorrect because avoiding all social situations involving alcohol may not be practical or sustainable in the long term. Choice B is important but is not specific to the client's alcohol recovery needs. Choice D is not the top priority compared to the importance of connecting with a support group for ongoing assistance and accountability.
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What principle about patient-nurse communication should guide a nurse's fear of 'saying the wrong thing' to a patient?
- A. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.
- B. The patient is more interested in talking to you than listening to what you have to say and is not likely to be offended.
- C. Considering the patient's history, there is little chance that the comment will do any actual harm.
- D. Most people with a mental illness have by necessity developed a high tolerance for forgiveness.
Correct Answer: A
Rationale: The correct principle guiding nurse-patient communication is that patients value genuine acceptance, respect, and concern. Choice A is the correct answer because showing genuine care and concern for the patient's situation fosters a positive and therapeutic relationship. Choice B is incorrect as effective communication involves active listening and responding appropriately, not assuming the patient is only interested in talking. Choice C is incorrect because a patient's history does not guarantee immunity to harm from inappropriate comments. Choice D is incorrect as it generalizes individuals with mental illness and forgiveness, which is not directly related to communication fears.
When changing the dressing for a client diagnosed with borderline personality disorder who has self-inflicted lacerations on the abdomen, which approach should the RN use?
- A. Provide detailed and thorough explanations while cleansing the wound.
- B. Perform the dressing change in a non-judgmental manner.
- C. Ask why the client cut their own abdomen in a non-threatening manner.
- D. Request assistance from another staff member for the dressing change.
Correct Answer: B
Rationale: The correct approach for the RN when changing the dressing for a client diagnosed with borderline personality disorder who has self-inflicted lacerations on the abdomen is to perform the dressing change in a non-judgmental manner. This approach helps maintain therapeutic rapport and respect for the client's situation. Choice A is incorrect because providing detailed and thorough explanations may not be as important as maintaining a non-judgmental attitude. Choice C is incorrect because asking why the client cut their own abdomen may come across as accusatory or threatening, which can be counterproductive in building trust. Choice D is incorrect because the RN should be equipped to handle the dressing change independently while ensuring a supportive and non-judgmental environment for the client.
The client is preparing to discontinue the use of a sedative-hypnotic medication. Which instruction should the nurse include?
- A. "You may experience withdrawal symptoms; these are usually mild."
- B. "The medication will need to be gradually tapered off."
- C. "You should increase your caffeine intake to stay alert."
- D. "There should be no change in your sleep patterns during discontinuation."
Correct Answer: B
Rationale: When discontinuing sedative-hypnotic medications, it is crucial to gradually taper them off to prevent withdrawal symptoms. Choice A is incorrect because withdrawal symptoms can be severe, not always mild. Choice C is incorrect as increasing caffeine intake can exacerbate sleep disturbances. Choice D is incorrect because changes in sleep patterns are expected during discontinuation of sedative-hypnotic medications.
Child protective services have removed 10-year-old Christopher from his parents' home due to neglect. Christopher reveals to the nurse that he considers the woman next door his 'nice' mom, that he loves school, and gets above-average grades. The strongest explanation of this response is:
- A. Temperament
- B. Genetic factors
- C. Resilience
- D. Paradoxical effects of neglect
Correct Answer: C
Rationale: Resilience is the ability to adapt and cope with adverse situations. In this case, Christopher's positive outlook, love for school, and good academic performance despite experiencing neglect demonstrate resilience. Choice A, 'Temperament,' refers to an individual's natural behavioral style and would not fully explain Christopher's response. Genetic factors (Choice B) are not directly related to his ability to cope with neglect. Choice D, 'Paradoxical effects of neglect,' does not fit the situation as Christopher's positive response is more indicative of resilience than paradoxical effects.
The RN is preparing medications for a client with bipolar disorder and notices that the client discontinued antipsychotic medication for several days. Which medication should also be discontinued?
- A. Lithium (Lithotabs).
- B. Benztropine (Cogentin).
- C. Alprazolam (Xanax).
- D. Magnesium (Milk of Magnesia).
Correct Answer: B
Rationale: The correct answer is Benztropine (Cogentin). Benztropine is commonly prescribed to manage side effects of antipsychotic medications. Therefore, if the antipsychotic medication is discontinued, there would be no need for Benztropine. Lithium is a mood stabilizer used in bipolar disorder, not directly related to antipsychotic use. Alprazolam is an anxiolytic, and Magnesium (Milk of Magnesia) is a laxative, neither of which is typically associated with antipsychotic medication use.