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A client is being educated by a healthcare professional about initiating a prescribed abstinence therapy using Disulfiram (Antabuse). What information should the client acknowledge understanding?
- A. Admit to others that they are a substance abuser.
- B. Remain alcohol-free for 12 hours before taking the first dose.
- C. Attend monthly Alcoholics Anonymous meetings.
- D. Completely abstain from heroin or cocaine use.
Correct Answer: B
Rationale: B: Before starting Disulfiram therapy, it is crucial for clients to be alcohol-free for a minimum of 12 hours to prevent adverse reactions. A: Admitting substance abuse is important, but it is not directly linked to the initiation of Disulfiram therapy. C: Attending Alcoholics Anonymous meetings is beneficial for support but not a specific requirement for starting Disulfiram. D: The focus of Disulfiram therapy is on alcohol abstinence, so abstaining from heroin or cocaine is not directly related to this medication.
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A client with depression remains in bed most of the day, declines activities, and refuses meals. Which nursing problem has the greatest priority for this client?
- A. Loss of interest in diversional activities.
- B. Social isolation.
- C. Refusal to address nutritional needs.
- D. Low self-esteem.
Correct Answer: C
Rationale: The correct answer is C: 'Refusal to address nutritional needs.' In this scenario, the client's refusal to eat and address their nutritional needs poses an immediate threat to their physical health. Without proper nutrition, the client is at risk of malnutrition and its associated complications. While addressing social isolation, low self-esteem, and loss of interest in diversional activities are important aspects of holistic care for a client with depression, ensuring proper nutrition takes precedence due to the critical impact it has on the client's physical well-being. Therefore, the priority is to address the client's refusal to eat and address their nutritional needs to prevent further deterioration of their health.
A male client with schizophrenia is admitted to the mental health unit after abruptly stopping his prescription for ziprasidone (Geodon) one month ago. Which question is most important for the RN to ask the client?
- A. Have you lost interest in the activities you once enjoyed?
- B. Is your ability to think or concentrate reduced?
- C. How many consecutive hours do you sleep at night?
- D. Do you hear sounds or voices that others do not hear?
Correct Answer: D
Rationale: In this scenario, the most critical question for the RN to ask the client relates to hallucinations. Hallucinations, such as hearing sounds or voices others do not hear, are a hallmark symptom of schizophrenia. This inquiry is vital for assessing the presence of psychotic symptoms and the potential relapse of the client's condition. Choices A, B, and C, although important in assessing overall mental health, do not directly address the core symptomatology of schizophrenia or the potential impact of discontinuing antipsychotic medication abruptly.
During a group session on anger management, a male adolescent client is fidgety, interrupts peers, and talks about his pets at home. What action should the nurse take?
- A. Allow the client to leave and return in 10 minutes.
- B. Explore the client's feelings about his pets and home life.
- C. Encourage his peers to help involve him in the activity.
- D. Redirect him by encouraging him to read from the handout.
Correct Answer: D
Rationale: The best nursing action in this scenario is to redirect the client by encouraging him to read from the handout. This approach helps refocus the client's attention on the topic being discussed, which is anger management. Choice A is not appropriate as it may disrupt the group session and does not address the client's behavior. Choice B, while important in understanding the client's background, does not address the immediate disruptive behavior. Choice C involves others to manage the client's behavior instead of direct intervention by the nurse, which may not be effective in this situation.
A client diagnosed with obsessive-compulsive disorder (OCD) engages in repetitive hand washing that lasts for several hours. Which strategy should the nurse use to manage this behavior?
- A. Encourage the client to continue the behavior to alleviate anxiety.
- B. Establish a routine schedule for hand washing.
- C. Gradually reduce the amount of time spent on the behavior.
- D. Ignore the behavior as much as possible.
Correct Answer: C
Rationale: In managing obsessive-compulsive disorder (OCD), it's crucial to gradually reduce the compulsive behavior to help the client learn to manage anxiety in a structured manner. Encouraging the client to continue the behavior (Choice A) would reinforce the cycle of compulsions. While establishing a routine schedule (Choice B) may provide some structure, it doesn't address the core issue of excessive hand washing. Ignoring the behavior (Choice D) may lead to worsening symptoms and does not help the client in managing their OCD effectively.
While sitting in the day room of the mental health unit, a male adolescent avoids eye contact, looks at the floor, and talks softly when interacting verbally with the RN. The two trade places, and the RN demonstrates the client's behaviors. What is the main goal of this therapeutic technique?
- A. Initiate a non-threatening conversation with the client.
- B. Dialog about the ineffectiveness of his interactions.
- C. Allow the client to identify the way he interacts.
- D. Discuss the client's feelings when he responds.
Correct Answer: C
Rationale: The main goal of the therapeutic technique described is to allow the client to identify the way he interacts. This technique helps promote self-awareness in the client by mirroring his behavior back to him, which can lead to insights about his own communication style. Option A is incorrect as the goal is not just to initiate conversation but to facilitate self-reflection. Option B is incorrect because the focus is not on discussing the ineffectiveness of the interactions but on self-awareness. Option D is incorrect as the primary aim is not to discuss the client's feelings but to help him recognize his interaction patterns.