Nokea
A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:
- A. naloxone (Narcan).
- B. labetalol (Normodyne).
- C. neostigmine (Prostigmin).
- D. thiothixene (Navane).
Correct Answer: A
Rationale: When a client becomes extremely somnolent with respiratory depression after being given an opiate drug, the physician is likely to order the administration of naloxone (Narcan). Naloxone is an opiate antagonist that attaches to opiate receptors, blocking or reversing the action of narcotic analgesics. Choices B, C, and D are incorrect. Labetalol is a beta blocker used for hypertension, neostigmine is an anticholinesterase agent used to treat myasthenia gravis and reverse neuromuscular blockade, and thiothixene is an antipsychotic agent used for psychiatric conditions.
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Who may legally give informed consent?
- A. an 86-year-old male with advanced Alzheimer's disease
- B. a 14-year-old girl needing an appendectomy who is not an emancipated minor
- C. a 14-year-old girl needing an appendectomy who is not an emancipated minor
- D. a 6-month-old baby needing bowel surgery
Correct Answer: C
Rationale: The correct answer is a 14-year-old girl needing an appendectomy who is not an emancipated minor. Informed consent can be given by individuals who are competent and not minors. Minors are generally unable to provide informed consent unless they are emancipated. Choice A is incorrect because an 86-year-old male with advanced Alzheimer's disease is considered incompetent to make decisions. Choice D is incorrect because a 6-month-old baby is unable to provide consent. Emancipated minors are an exception to the minor rule, as they can provide consent for their own treatment.
Which statement reflects a primary belief of psychiatric mental health nursing?
- A. Most people have the potential to change and grow.
- B. Every person is worthy of dignity and respect.
- C. Human needs are individual to each person.
- D. Some behaviors have no meaning and cannot be understood.
Correct Answer: B
Rationale: The correct answer reflects a primary belief of psychiatric mental health nursing, which is that every person is worthy of dignity and respect. This belief forms the foundation of providing holistic and compassionate care in mental health nursing. While it is true that most people have the potential to change and grow, this choice does not directly address a core belief of mental health nursing. Human needs being individual to each person is a general principle of nursing care but does not specifically capture a primary belief in psychiatric mental health nursing. The statement that some behaviors have no meaning and cannot be understood contradicts the fundamental principle that all behavior has meaning and can be understood from the client's perspective in psychiatric mental health nursing.
Mrs. Owens is the 81-year-old mother of Jonathan, who is 54 years old. Jonathan has had schizophrenia since he was 16 years old. Which of Mrs. Owens's concerns is likely to predominate?
- A. "Will my retirement funds outlast me?"?
- B. "Who will handle my funeral arrangements?"?
- C. "What will become of Jonathan when I am gone?"?
- D. "How can I communicate effectively with Jonathan's physician?"?
Correct Answer: C
Rationale: The most prominent concern for Mrs. Owens is likely what will happen to her son, Jonathan, after she passes away. While retirement fund sustainability is important, it is not likely to be her primary concern. Funeral arrangements, although significant, are secondary to the welfare of her son with schizophrenia. The question of how to communicate with Jonathan's physician is less likely to be a predominant concern since Mrs. Owens has likely already addressed this issue over the 38 years of managing her son's care.
The nurse is teaching a client about the use of Rifampin for prophylaxis after an exposure to meningitis. What change in bodily functions should the nurse advise the client about?
- A. The client's urine might turn blue
- B. The client remains infectious to others for 48 hours
- C. The client's contact lenses might be stained orange
- D. The client's skin might take on a crimson glow
Correct Answer: C
Rationale: Rifampin causes orange discoloration of body fluids, which can permanently stain soft contact lenses, requiring client education to prevent concern or damage.
A woman asks, "How much alcohol can I safely drink while pregnant?"? The nurse's best response is:
- A. "The amount of alcohol that is safe during pregnancy is unknown."?
- B. "Consuming one or two beers or glasses of wine a day is considered safe for a healthy pregnant woman."?
- C. "Drinking three or more drinks on any given occasion is the only harmful type of drinking during pregnancy."?
- D. "You can have a drink to help you relax and get to sleep at night."?
Correct Answer: A
Rationale: The correct answer is, "The amount of alcohol that is safe during pregnancy is unknown."? It is crucial for pregnant women to avoid alcohol as there is no known safe amount during pregnancy. Consuming any amount of alcohol can harm the developing fetus and increase the risk of fetal alcohol syndrome, a condition characterized by mental and physical abnormalities in infants. Choices B, C, and D are incorrect because they provide misleading information that can potentially harm the fetus. Pregnant women should abstain from alcohol to ensure the health and well-being of their baby.