Nokea
A male client is admitted for evaluation of a sudden hearing loss. No physical cause can be found for his sudden deafness; however, a friend reveals that the client's fiancée recently canceled their engagement, saying that she needed more time to think about the marriage. The client's deafness is an example of:
- A. Conversion reaction
- B. Hypochondriasis
- C. Reaction formation
- D. Histrionic personality disorder
Correct Answer: A
Rationale: Sudden deafness after emotional stress, without physical cause, indicates a conversion reaction, where psychological distress manifests physically.
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When planning care for a woman who is admitted in labor, it is most important for the nurse to obtain which of the following information about the client?
- A. Age of the client and due date
- B. Frequency and duration of contractions
- C. Whether the membranes have ruptured
- D. Who will be assisting the woman during labor
Correct Answer: B
Rationale: Contraction frequency and duration indicate labor progress and urgency, guiding immediate care. Age, due date, membrane status, and support persons are secondary.
A client is receiving lithium carbonate 600 mg T.I.D. to treat bipolar disorder. Which of these indicate early signs of toxicity?
- A. Ataxia and coarse hand tremors
- B. Vomiting, diarrhea and lethargy
- C. Pruritus, rash and photosensitivity
- D. Electrolyte imbalance and cardiac arrhythmias
Correct Answer: B
Rationale: Vomiting, diarrhea, and lethargy are early signs of lithium toxicity.
While teaching the family of a child who will take phenytoin (Dilantin) regularly for seizure control, it is most important for the nurse to teach them about which of the following actions?
- A. Maintain good oral hygiene and dental care
- B. Omit medication if the child is seizure free
- C. Administer acetaminophen to promote sleep
- D. Serve a diet that is high in iron
Correct Answer: A
Rationale: Swollen and tender gums occur often with use of phenytoin. Good oral hygiene and regular visits to the dentist should be emphasized.
A client in labor with a history of a previous cesarean birth has chosen to attempt a vaginal birth. During labor, which finding would be most concerning to the nurse?
- A. Cessation of contractions and maternal tachycardia
- B. Fetal tachycardia with moderate variability
- C. Increased anxiety and discomfort with contractions
- D. Painful, strong contractions every 3-4 minutes
Correct Answer: A
Rationale: Cessation of contractions with maternal tachycardia (A) suggests uterine rupture, a life-threatening emergency in VBAC due to scar dehiscence. Fetal tachycardia (B) is concerning but less specific, anxiety (C) is expected, and regular contractions (D) are normal.
The nurse is caring for a client with bipolar disorder who is hospitalized for an acute manic episode. Which of the following actions would the nurse expect to be included in the client's plan of care? Select all that apply.
- A. Ask the client to plan an outing for the unit
- B. Assign the client to a private room
- C. Assist client in choosing appropriate clothing
- D. Include the client in group therapy sessions
- E. Schedule the client for physical activity with a staff member
- F. Seat the client with other clients in the dining room for meals
Correct Answer: B,C,D,E,F
Rationale: During a manic episode, a private room (B) minimizes stimuli, appropriate clothing (C) supports dignity, group therapy (D) fosters socialization, physical activity (E) channels energy, and dining with others (F) promotes normalcy. Planning an outing (A) is inappropriate due to impulsivity risks.