Nokea
A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, the nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer?
- A. Diphenhydramine (Benadryl)
- B. Propranolol (Inderal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: A
Rationale: The correct answer is A: Diphenhydramine (Benadryl). Dystonic reactions are extrapyramidal side effects commonly seen with antipsychotic medications. Diphenhydramine is a first-line treatment for dystonic reactions due to its anticholinergic properties. It helps block the excessive dopamine activity in the brain that causes these reactions. Propranolol (B) is a beta-blocker and not typically used for dystonic reactions. Risperidone (C) and Aripiprazole (D) are antipsychotic medications themselves and would not be used to treat dystonic reactions caused by antipsychotic medications.
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A client with signs and symptoms of double pneumonia states,"I will not agree to hospital admission unless my shaman is allowed to continue helping me." Which would be an appropriate nursing intervention?
- A. Tell the client that the shaman is not allowed in the emergency department.
- B. Have the shaman meet the attending physician at the hospital.
- C. Have the family talk the client into admission without the shaman.
- D. Explain to the client that the shaman is responsible for the client's condition.
Correct Answer: B
Rationale: The correct answer is B. Having the shaman meet the attending physician at the hospital is the most appropriate nursing intervention because it allows for collaboration between traditional beliefs and modern medical care. This approach respects the client's cultural and spiritual preferences while ensuring the client receives necessary medical treatment. It also helps establish a supportive and holistic care environment.
Choice A is incorrect because denying the shaman access may lead to resistance from the client and hinder effective communication and trust-building. Choice C is inappropriate as it disregards the client's autonomy and may create conflict within the family. Choice D is incorrect as blaming the shaman for the client's condition is disrespectful and unprofessional.
A patient has come to the clinic to discuss the stress she is experiencing because of failing two exams at school. Initially, she described her failures as 'the worst thing that has ever happened to me,' and she stated, 'There is absolutely nothing I can do to pass this course now.' In response to the nurse's questions, the nurse finds out there are three more equally weighted exams scheduled for the course in question. The nurse and patient collaborate and decide to use interventions to facilitate emotion-focused coping. Which additional comment from the patient would the nurse identify as providing support for this decision?
- A. You've got to figure out something for me to do to get me out of this situation!
- B. This is a waste of time because absolutely nothing you or I can do will make it any better.
- C. I overreacted; surely together we can figure out something for me to do.
- D. This is the worst thing that could ever happen to me. I'm nothing but a failure.
Correct Answer: C
Rationale: The correct answer is C because the patient's statement shows a shift in perspective from hopelessness to a willingness to collaborate and problem-solve. By acknowledging the possibility of working together to find a solution, the patient demonstrates openness to coping strategies. Choice A displays frustration without a willingness to participate actively. Choice B reinforces hopelessness and a defeatist attitude. Choice D reinforces negative self-perception without any indication of openness to change. In summary, choice C aligns with emotion-focused coping by showing a willingness to explore solutions collaboratively.
Based on assessment data, the nurse formulates the nursing diagnosis for a patient as sleep pattern disturbance. After teaching the patient how to relax before bedtime, the nurse determines that the teaching was effective by which outcome?
- A. Discusses feelings about not being able to fall asleep
- B. Reports feeling rested on awakening in the morning within 3 days
- C. Requests sleeping medication each night before bedtime
- D. Is able to sleep for short intervals throughout the night
Correct Answer: B
Rationale: The correct answer is B because feeling rested upon awakening indicates improved sleep quality, reflecting effective teaching on relaxation techniques. Choice A does not directly measure the effectiveness of the teaching intervention. Choice C indicates reliance on medication rather than improved sleep hygiene. Choice D, sleeping for short intervals, does not necessarily signify improved sleep quality.
Which statement by a patient would lead the nurse to suspect unsuccessful completion of the psychosocial developmental task of infancy?
- A. I know how to do things right, so I prefer jobs where I work alone rather than on a team.'
- B. I do not allow other people to truly get to know me.'
- C. I depend on frequent praise from others to feel good about myself.'
- D. I usually need to do things several times before I get them right.'
Correct Answer: C
Rationale: The correct answer is C because depending on frequent praise from others to feel good about oneself indicates a lack of self-confidence and self-esteem, which are key components of successful completion of the psychosocial developmental task of infancy according to Erikson's theory. This statement suggests an inability to develop a sense of autonomy and self-reliance, which are crucial in the infancy stage.
Choice A is incorrect because preferring to work alone rather than on a team may indicate a preference for autonomy, which is a positive trait related to the successful completion of the task of autonomy vs. shame and doubt in infancy.
Choice B is incorrect because not allowing others to truly get to know oneself could indicate introversion or privacy preferences, which may not necessarily suggest unsuccessful completion of the infancy developmental task.
Choice D is incorrect because needing to do things several times before getting them right may indicate a learning style or perfectionism rather than a sign of unsuccessful completion of the psychosocial developmental task of infancy.
Forensic nursing combines scientific knowledge and inquiry in an effort to serve:
- A. Victims of crime
- B. Perpetrators of violence
- C. Victims and perpetrators of crime
- D. Families of crime victims
Correct Answer: C
Rationale: The correct answer is C because forensic nursing serves both victims and perpetrators of crime. Forensic nurses provide care, collect evidence, and testify in legal proceedings for all individuals involved in a crime. Choice A is incorrect because forensic nursing is not exclusive to victims. Choice B is incorrect as it does not encompass the holistic approach of forensic nursing. Choice D is incorrect as it focuses solely on the families of crime victims, rather than the individuals directly involved.