Nokea
A 20-year-old female client who tried lysergic acid diethylamide (LSD) as a teen tells the nurse that she has bad dreams that make her want to kill herself. Which is the explanation for this occurrence?
- A. These occurrences are referred to as 'holdover reactions' to the drug.
- B. These are flashbacks to a time when the client had a 'bad trip.'
- C. The drug is still in the client’s body and causing these reactions.
- D. The client is suicidal and should be on one-to-one precautions.
Correct Answer: B
Rationale: LSD can cause flashbacks (B), where users re-experience effects like bad dreams years later, especially from a 'bad trip.' Holdover reactions (A) is not a term, LSD is not stored long-term (C), and suicidal ideation (D) requires assessment but is not the explanation.
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When the nursing team plans the care of a client with Guillain-Barré syndrome, which assessment finding most accurately determines whether the client is developing ineffective breathing?
- A. Respiratory rate is 24.
- B. Skin is flushed.
- C. Activity is decreased.
- D. Pulse oximetry reading is 82%.
Correct Answer: D
Rationale: A pulse oximetry reading of 82% indicates significant hypoxemia, suggesting ineffective breathing, which is a critical concern in Guillain-Barré syndrome due to potential respiratory muscle weakness.
The nurse is caring for a client diagnosed with encephalitis. Which is an expected outcome for the client?
- A. The client will regain as much neurological function as possible.
- B. The client will have no short-term memory loss.
- C. The client will have improved renal function.
- D. The client will apply hydrocortisone cream daily.
Correct Answer: A
Rationale: The goal for encephalitis is to maximize neurological recovery (A), as inflammation may cause deficits. No memory loss (B) is unrealistic, renal function (C) is unrelated, and hydrocortisone cream (D) is not indicated.
The client who has expressive aphasia is having difficulty communicating with the nurse. Which action by the nurse would be most helpful?
- A. Position the client facing the nurse
- B. Enunciate directions very slowly
- C. Use gestures and body language
- D. Ask the client to point to needed objects
Correct Answer: D
Rationale: Having the client face the nurse will not aid the client in expressing his or her needs. The nurse’s slow enunciation of directions will not aid the client in expressing his or her needs. Using gestures and body language will not aid the client in expressing his or her needs. Asking the client to point to needed objects would be most helpful when the client is having difficulty communicating with the nurse.
The husband of a client who is an alcoholic tells the nurse, 'I don’t know what to do. I don’t know how to deal with my wife’s problem.' Which response would be most appropriate by the nurse?
- A. It must be difficult. Maybe you should think about leaving.'
- B. I think you should attend Alcoholics Anonymous.'
- C. I think that Alanon might be very helpful for you.'
- D. You should not enable your wife’s alcoholism.'
Correct Answer: C
Rationale: Alanon (C) supports families of alcoholics, offering coping strategies. Suggesting leaving (A) is judgmental, AA (B) is for alcoholics, and accusing enabling (D) may alienate.
The client comes to the clinic and reports a sudden drooping of the left side of the face and complains of pain in that area. The nurse notes that the client cannot wrinkle the forehead or close the left eye. Which condition should the nurse suspect?
- A. Bell's palsy.
- B. Right-sided stroke.
- C. Tetany.
- D. Mononeuropathy.
Correct Answer: A
Rationale: Bell’s palsy (A) causes unilateral facial drooping, inability to wrinkle the forehead, and eye closure issues due to facial nerve paralysis. Right-sided stroke (B) affects the opposite side, tetany (C) involves muscle spasms, and mononeuropathy (D) is less specific.