Nokea
A client is taking hydrocodone (Vicodin) for chronic back pain. The client has required an increase in the dose and asks whether this means he is addicted to Vicodin. The nurse should base her reply on the knowledge that:
- A. the client's body has developed tolerance, requiring more drug to produce the same effect.
- B. the client is preoccupied with getting the drug and is experiencing loss of control, indicating drug dependence.
- C. addiction is the term used to describe physical dependence with withdrawal symptoms and tolerance.
- D. the client has a dual diagnosis of substance abuse and chronic back pain.
Correct Answer: A
Rationale: Drug tolerance is characterized by the ability to ingest a larger dose without adverse effect and decreased sensitivity to the substance. Substance dependence is a severe condition indicating physical problems and disruption of the person's social, family, and work life. The psychological behaviors related to substance use are termed addiction. Dual diagnosis is the coexistence of substance abuse and psychiatric disorders.
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A client is having psychological counseling for problems communicating with his mother. Which model of stress is the most useful in reference to this stressor?
- A. Adaptation Model
- B. Stimulus-Based Model
- C. Transaction-Based Model
- D. Selye's Model of Stress
Correct Answer: C
Rationale: The Transaction-Based Model is, according to R.S. Lazarus, a state that Stimulus theory and Response theory do not consider individual differences. He takes into account cognitive processes that intervene between the encounter and the reaction and the factors that affect the nature of this process. He includes mental and psychological components or responses as part of his concept of stress (Person-Environment Transactions).
A client is admitted with a diagnosis of Multiple Drug Use. The nurse should plan care based on knowledge that:
- A. Multiple drug use is very uncommon
- B. People might use more than one drug to enhance the effect or relieve withdrawal symptoms
- C. Alcohol and barbiturates used together are not dangerous because one is a stimulant and the other is a depressant
- D. Assessment and intervention are easier with multiple drug use because of the synergistic effect
Correct Answer: B
Rationale: Multiple drug use is common to enhance effects or relieve withdrawal symptoms, complicating assessment and intervention due to varied drug interactions.
A primary belief of psychiatric mental health nursing is:
- 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: Every person is worthy of dignity and respect. Every person has the potential to change and grow. All people have basic human needs in common with others. All behavior has meaning and can be understood from the client's perspective.
A family member of a client with a diagnosis of Schizophrenia asks about the prognosis. The nurse's response is based on the knowledge that schizophrenia:
- A. affects women more often than men.
- B. is usually diagnosed between the ages of 15 and 45.
- C. is a chronic, deteriorating disease with periods of remission.
- D. is diagnosed later in women due to a protective hormone effect.
Correct Answer: C
Rationale: Although all of the choices are true about schizophrenia, only Choice 3 answers the question asked.
When planning intervention for a client during a crisis, which of the following outcomes is most appropriate?
- A. The client should explore deep psychological problems.
- B. The client should express positive feelings about event.
- C. The client should identify needs that are threatened by the event.
- D. The client should use constructive coping mechanisms.
Correct Answer: D
Rationale: The primary goal of crisis intervention is to relieve the symptoms of anxiety and foster constructive coping. Previous psychological issues might recur during crisis, but the focus is on short-term resolution of the current problem. At the end, the nurse credits a client for positive changes and helps him or her understand what was learned. This allows the client to use the learned coping mechanisms when new problems arise.