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A client with a history of substance abuse is admitted to the hospital for treatment of a new illness. Which of the following is the most important to assess upon admission?
- A. History of recent drug use.
- B. Current employment status.
- C. Family history of mental illness.
- D. Recent weight changes.
Correct Answer: A
Rationale: Assessing the history of recent drug use is crucial when admitting a client with a history of substance abuse. Understanding recent drug use helps in managing potential withdrawal symptoms, preventing drug interactions with the new treatment, and ensuring appropriate care. Assessing current employment status (choice B) is important for social and financial support but is not as crucial as assessing recent drug use in this scenario. Family history of mental illness (choice C) and recent weight changes (choice D) are also important aspects of assessment but are not as immediate and critical as evaluating recent drug use in a client with a history of substance abuse.
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The RN is providing education about strategies for a safety plan for a female client who is a victim of intimate partner violence. Which strategies should be included in the safety plan? (SOA)
- A. Purchase a gun for protection.
- B. Establish a code with family and friends to signal violence.
- C. Take a self-defense course focused on protecting oneself.
- D. Prepare a bag with extra clothes for self and children.
Correct Answer: B
Rationale: B: Establishing a code with family and friends is important as it helps discreetly communicate the need for help without alerting the abuser. D: Having a bag prepared with essentials ensures the victim can swiftly leave if required. A: Purchasing a gun can escalate violence and is not a recommended safety strategy. C: Taking a self-defense course focused on protecting oneself is beneficial, but courses that involve retaliation are not recommended as they can increase risk and escalate violence.
A healthcare provider is evaluating a client's response to a new antianxiety medication. Which client statement indicates a positive response to the medication?
- A. "I feel more relaxed and less anxious."
- B. "I am sleeping less and feel more energetic."
- C. "I have not noticed any changes in my anxiety levels."
- D. "I have more difficulty concentrating than before."
Correct Answer: A
Rationale: The correct answer is A: "I feel more relaxed and less anxious." A positive response to antianxiety medication is characterized by reduced anxiety and increased relaxation. Choice B, which mentions sleeping less and feeling more energetic, suggests potential side effects rather than a positive response to the medication. Choice C indicates no change in anxiety levels, which is not indicative of a positive response. Choice D, mentioning difficulty concentrating, is also a sign of a negative response to antianxiety medication as it may suggest cognitive impairment.
A client who is known to abuse drugs is admitted to the psychiatric unit. Which medication should the nurse anticipate administering to a client who is exhibiting benzodiazepine withdrawal symptoms?
- A. Diphenhydramine (Benadryl)
- B. Perphenazine (Trilafon)
- C. Isocarboxazid (Marplan)
- D. Chlordiazepoxide (Librium)
Correct Answer: D
Rationale: Chlordiazepoxide (Librium) is the correct choice for managing benzodiazepine withdrawal symptoms. Benzodiazepines are commonly used drugs that can lead to physical dependence, and abrupt discontinuation can result in withdrawal symptoms. Chlordiazepoxide, a benzodiazepine itself, is often used in a controlled manner to taper off the drug gradually and manage withdrawal symptoms effectively. Choice A, Diphenhydramine, is an antihistamine and not typically used to manage benzodiazepine withdrawal. Choice B, Perphenazine, is an antipsychotic medication used to treat psychotic disorders, not specifically benzodiazepine withdrawal symptoms. Choice C, Isocarboxazid, is a monoamine oxidase inhibitor (MAOI) used in the treatment of depression and not indicated for benzodiazepine withdrawal.
A male hospital employee is pushed out of the way by a female employee because of an oncoming gurney. The pushed employee becomes very angry and swings at the female employee. Both employees are referred for counseling with the staff psychiatric nurse. Which factor in the pushed employee's history is most related to the reaction that occurred?
- A. Is worried about losing his job to a woman.
- B. Tortured animals as a child.
- C. Was physically abused by his mother.
- D. Hates to be touched by anyone.
Correct Answer: C
Rationale: The correct answer is 'C: Was physically abused by his mother.' The pushed employee's aggressive reaction can be attributed to his history of physical abuse. Research suggests that individuals who have experienced physical abuse may exhibit heightened aggressive responses due to trauma and learned behavior. Choices A, B, and D are incorrect: A is a stereotype-based assumption that does not have a direct correlation with the aggressive behavior observed; B, torturing animals, is concerning behavior but not directly linked to the aggressive response in this scenario; D, hating to be touched, is not the most relevant factor considering the situation described.
The mental health team is determining treatment options for a male patient who is experiencing psychotic symptoms. Which question(s) should the team answer to determine whether a community outpatient or inpatient setting is most appropriate? Select all that apply.
- A. Is the patient expressing suicidal thoughts?
- B. Does the patient have intact judgment and insight into his situation?
- C. Does the patient have experiences with either community or inpatient mental healthcare facilities?
- D. Does the patient require a therapeutic environment to support the management of psychotic symptoms?
Correct Answer: C
Rationale: To determine whether a community outpatient or inpatient setting is most appropriate for a patient experiencing psychotic symptoms, it is crucial to consider if the patient has had experiences with either community or inpatient mental healthcare facilities. This helps in assessing the familiarity and comfort level of the patient in those settings, aiding in decision-making regarding the level of care needed. The other choices, such as assessing suicidal thoughts (choice A), judgment and insight (choice B), and the need for a therapeutic environment (choice D), are important considerations in the overall treatment plan but do not directly address the setting appropriateness between community outpatient or inpatient care.