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A client with a diagnosis of schizophrenia is prescribed risperidone (Risperdal). Which statement by the client indicates a need for further teaching?
- A. I can stop taking this medication once I feel better.
- B. I need to avoid foods that are high in tyramine.
- C. I should avoid drinking alcohol while taking this medication.
- D. This medication may cause drowsiness, so avoid driving.
Correct Answer: A
Rationale: The correct answer is A. The statement 'I can stop taking this medication once I feel better' indicates a need for further teaching. Antipsychotic medications, like risperidone, should be taken consistently even when symptoms improve to prevent relapse. Choice B is incorrect because avoiding foods high in tyramine is unrelated to risperidone. Choice C is incorrect as avoiding alcohol is a standard precaution with many medications. Choice D is incorrect because being cautious about drowsiness and avoiding driving is a common safety measure associated with risperidone.
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A LPN/LVN is preparing to care for a dying client, and several family members are at the client's bedside. Select the therapeutic techniques that the nurse would use when communicating with the family. Select one that does not apply.
- A. Discourage reminiscing
- B. Make decisions for the family
- C. Encourage expression of feelings, concerns, and fears
- D. Explain everything that is happening to all family members
Correct Answer: B
Rationale: Encouraging the expression of feelings, concerns, and fears is a therapeutic technique that helps the family cope with the situation and express their emotions. This approach fosters trust and emotional release. Making decisions for the family is not appropriate because it takes away their autonomy and control during a difficult time. Discouraging reminiscing may hinder the family's coping mechanisms by discouraging them from sharing memories and finding comfort in the past. Explaining everything that is happening to all family members promotes transparency and understanding, which can help reduce anxiety and fear.
A client is preparing to attend a Gamblers Anonymous meeting for the first time. The prototype used by this group is the 12-step program developed by Alcoholics Anonymous. Number in order of priority how the steps would be addressed.
- A. Admitting to oneself and to another human being the exact nature of one's wrongs
- B. Acknowledging that one is entirely ready to have his or her defects of character removed
- C. Admitting that oneself is powerless over gambling and that one's life has become unmanageable
- D. Making an effort to practice the 12-step principles in all affairs, and to carry out this message to other compulsive gamblers
Correct Answer: D
Rationale: The correct order of addressing the 12-step program typically begins with admitting powerlessness over the addiction and recognizing the unmanageability of one's life (Choice C). Following this, individuals move towards acknowledging their wrongs and sharing them with others (Choice A), then being ready to work on changing their character defects (Choice B), and finally, integrating the 12-step principles into their daily lives and helping others (Choice D). Choices A, B, and C are important steps in the program but come after admitting powerlessness and unmanageability, which is why Choice D is the correct answer.
For a female client with major depressive disorder reporting feelings of hopelessness and helplessness, what is the nurse's priority intervention?
- A. Encourage the client to join a support group.
- B. Refer the client for cognitive-behavioral therapy (CBT).
- C. Assess the client's risk for suicide.
- D. Suggest the client participate in daily exercise.
Correct Answer: C
Rationale: The correct answer is to assess the client's risk for suicide. When a client expresses feelings of hopelessness and helplessness, it indicates a high risk of self-harm or suicide. Therefore, the priority intervention should be to assess the client's safety. Encouraging the client to join a support group (choice A) may be beneficial but not the priority at this time. Referring the client for cognitive-behavioral therapy (CBT) (choice B) and suggesting daily exercise (choice D) are important interventions in managing depression but assessing the risk for suicide takes precedence due to the immediate safety concern.
A client with a history of alcohol dependence tells the nurse that he has been sober for three months but has recently started drinking again. What should the nurse do next?
- A. Ask the client why he started drinking again.
- B. Provide information about support groups for sobriety.
- C. Discuss the consequences of drinking on his health.
- D. Encourage the client to express his feelings about relapse.
Correct Answer: D
Rationale: Encouraging the client to express his feelings about relapse is the most appropriate action for the nurse to take in this situation. This approach allows the nurse to address the underlying emotions and factors contributing to the relapse. Choice A, asking the client why he started drinking again, may come across as judgmental and might not be as effective in exploring the client's emotions. Choice B, providing information about support groups, is important but should come after addressing the client's current emotional state. Choice C, discussing the consequences of drinking, may be necessary at some point, but initially, the focus should be on the client's feelings and emotions surrounding the relapse.
The community health nurse talks to a male client who has bipolar disorder. The client explains that he sleeps 4 to 5 hours a night and is working with his partner to start two new businesses and build an empire. The client stopped taking his medications several days ago. What nursing problem has the highest priority?
- A. Excessive work activity.
- B. Decreased need for sleep.
- C. Medication management.
- D. Inflated self-esteem.
Correct Answer: C
Rationale: The most important nursing problem is medication management (C) because compliance with the medication regimen will help prevent hospitalization. The client is also exhibiting signs of mania, such as excessive work activity (A), decreased need for sleep (B), and inflated self-esteem (D); however, these problems do not have the priority of medication management. Managing the medications is crucial to stabilize the client's condition and prevent potential harm associated with untreated bipolar disorder.