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A client with schizophrenia is being discharged home after an extended stay in a psychiatric hospital. Which statement by the client indicates that further teaching about medication management is needed?
- A. "I will take my medication only when I feel like it."
- B. "I need to follow up with my psychiatrist regularly."
- C. "I will notify my healthcare provider if I experience side effects."
- D. "I should avoid alcohol while on my medication."
Correct Answer: A
Rationale: The correct answer is A. This statement indicates a lack of understanding about medication management for schizophrenia. Medications for schizophrenia should be taken consistently as prescribed for optimal effectiveness, regardless of how the client feels. Choice B is a correct statement as regular follow-up with a psychiatrist is important for monitoring progress and adjusting treatment. Choice C demonstrates good awareness of potential side effects and the need for communication with healthcare providers. Choice D reflects appropriate knowledge as alcohol can interact with medications and may reduce their effectiveness.
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Narcan was administered to an adult client following a suicide attempt with an overdose of hydrocodone bitartrate (Vicodin). Within 15 minutes, the client is alert and oriented. In planning nursing care, which intervention has the highest priority at this time?
- A. Encourage the client to increase fluid intake.
- B. Obtain the client's serum Vicodin level.
- C. Observe the client for further narcotic effects.
- D. Determine the client's reason for attempting suicide.
Correct Answer: C
Rationale: Observing the client for further narcotic effects is the priority at this time. It is crucial to monitor the client closely to prevent a relapse of symptoms or potential complications from the overdose. Encouraging fluid intake, obtaining serum Vicodin levels, and determining the reason for the suicide attempt are important but are secondary to ensuring the client's immediate safety and well-being by observing for any lingering effects of the narcotic.
A client with alcohol use disorder is being treated in a rehabilitation facility. Which behavior indicates that the client is making progress in recovery?
- A. Attends all scheduled therapy sessions regularly.
- B. Is participating in group therapy and sharing experiences.
- C. Completes a work-study program.
- D. Has a decreased need for psychiatric medication.
Correct Answer: B
Rationale: The correct answer is B. Participation in group therapy and sharing experiences is a positive sign of progress in recovery for a client with alcohol use disorder. It fosters peer support, allows for personal insight, and encourages social interaction, which are essential aspects of the recovery process. Choice A, attending all scheduled therapy sessions regularly, is important but may not necessarily indicate the same level of progress as active participation in group therapy. Choice C, completing a work-study program, is not directly related to the client's recovery from alcohol use disorder. Choice D, having a decreased need for psychiatric medication, is not necessarily a reliable indicator of progress in recovery from alcohol use disorder, as medication management is a separate aspect of treatment.
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 with major depressive disorder is prescribed lithium carbonate. Which finding should the RN report to the healthcare provider?
- A. Serum lithium level of 0.8 mEq/L
- B. Blood urea nitrogen (BUN) level of 16 mg/dL
- C. Serum sodium level of 138 mEq/L
- D. Urine output of 800 mL in 24 hours
Correct Answer: B
Rationale: The correct answer is B. Elevated BUN levels may indicate renal impairment, which is crucial to report for clients on lithium due to its potential kidney effects. Option A, a serum lithium level of 0.8 mEq/L, is within the therapeutic range for lithium and does not require immediate reporting. Option C, a serum sodium level of 138 mEq/L, is within the normal range and not directly related to lithium therapy. Option D, urine output of 800 mL in 24 hours, may indicate a need for further assessment but is not the most critical finding to report compared to potential renal impairment indicated by an elevated BUN level.
A female client engages in repeated checks of door and window locks, a behavior that prevents her from arriving on time and interferes with her ability to function effectively. What action should the nurse take?
- A. Ask the client why she checks the locks.
- B. Discuss checking the time frequently.
- C. Determine the type and size of the locks.
- D. Plan a list of activities to be carried out daily.
Correct Answer: D
Rationale: Planning a list of daily activities can help the client manage her time better and reduce the impact of her compulsive behaviors. Option A is incorrect because simply asking why the client checks the locks may not address the underlying issue effectively. Option B is not relevant to the compulsive behavior of checking locks. Option C does not directly address the client's compulsive behavior but focuses on the physical attributes of the locks.