Nokea
A client is given the diagnosis of generalized anxiety disorder and is prescribed a benzodiazepine. The client should be instructed on which of the following?
- A. Monthly laboratory tests are needed to monitor drug level.
- B. Foods that contain tyramine should be avoided
- C. Benzodiazepines do not cause physical dependence.
- D. Benzodiazepines and alcohol can be dangerous
Correct Answer: D
Rationale: Lab tests aren’t routine for benzodiazepines. Tyramine avoidance applies to MAOIs, not benzodiazepines. Benzodiazepines can cause dependence, so that’s false. Combining benzodiazepines with alcohol increases CNS depression, posing risks like respiratory failure, making it critical to instruct the client on this danger.
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In developing a nursing care plan for an adult with a mental health disorder, the nurse knows the goals that are set must be:
- A. Important to the client
- B. Evaluated on a weekly basis
- C. Achievable by client discharge
- D. Approved by the physician
Correct Answer: A
Rationale: Client-important goals boost engagement. Weekly evaluation is useful but not mandatory. Discharge-tied goals may not fit long-term needs. Physician approval is secondary to client-centered planning.
A nurse is caring for a client who has depression and states that she is too tired to get out of bed or dress. Which of the following statements by the nurse is appropriate?
- A. If you do not get out of bed, you will not receive your meal.'
- B. You really need to follow the rules of the unit and get out of bed.'
- C. I will help you sit up and get your slippers on.'
- D. You should rest in bed until you feel able to take part in unit activities.'
Correct Answer: C
Rationale: Threatening to withhold meals is coercive. Enforcing rules dismisses the client’s fatigue. Offering help supports the client’s engagement without pressure, addressing depression’s lethargy. Encouraging rest may reinforce withdrawal, worsening depression.
An older adult is given the diagnosis of depression and is started on medication. Which group of medications would be appropriate for the depressed older adult?
- A. Selective serotonin reuptake inhibitors (SSRIs)
- B. Benzodiazepines
- C. Hypnotics
- D. Monoamine oxidase inhibitors
Correct Answer: A
Rationale: SSRIs are often the first-line treatment for depression in older adults due to their favorable side effect profile, including lower risk of sedation and falls compared to other options. Benzodiazepines are not typically used for depression as they treat anxiety and can increase the risk of falls and confusion in older adults. Hypnotics are used for sleep issues, not as antidepressants, and don’t address the core symptoms of depression. Monoamine oxidase inhibitors are effective but often reserved for cases where other treatments fail due to their dietary restrictions and potential for serious side effects.
Which medication would the nurse expect to be prescribed for a client with moderate stages of Alzheimer's disease?
- A. Risperidone (Risperdal)
- B. Alprazolam (Xanax)
- C. Donepezil (Aricept)
- D. Haloperidol (Haldol)
Correct Answer: C
Rationale: Risperidone is an antipsychotic used for behavioral issues in dementia, not cognitive decline. Alprazolam is an anxiolytic, not indicated for Alzheimer’s cognitive symptoms. Donepezil is a cholinesterase inhibitor commonly prescribed to improve cognition and slow symptom progression in moderate Alzheimer’s. Haloperidol, an antipsychotic, treats agitation but doesn’t enhance cognition and has higher side effect risks.
A hospitalized client sees snakes on the walls of the hospital room and becomes anxious. This is an example of which of the following?
- A. Hallucinations
- B. Delirium
- C. Delusion
- D. Psychosis
Correct Answer: A
Rationale: Hallucinations involve perceiving things that aren’t present, like seeing snakes, fitting the client’s experience. Delirium is a broader state of confusion that may include hallucinations but isn’t specific to this symptom alone. Delusions are false beliefs, not perceptions. Psychosis is a general term that can include hallucinations but isn’t as precise as the specific symptom described.