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A nurse is caring for a client who has a history of opioid use disorder. Which medication should the nurse anticipate administering to prevent withdrawal symptoms?
- A. Methadone
- B. Disulfiram
- C. Naloxone
- D. Bupropion
Correct Answer: A
Rationale: The correct answer is A: Methadone. Methadone is a long-acting opioid agonist that helps prevent withdrawal symptoms in clients with opioid use disorder by reducing cravings and preventing withdrawal symptoms without causing euphoria. Disulfiram (B) is used for alcohol use disorder, Naloxone (C) is an opioid antagonist used for opioid overdose reversal, and Bupropion (D) is an antidepressant that is not indicated for opioid withdrawal. By choosing Methadone, the nurse is providing appropriate pharmacological support for the client's opioid use disorder.
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A nurse is assessing a client who has bipolar disorder and is experiencing a depressive episode. Which of the following findings should the nurse expect?
- A. Inability to carry out a simple task
- B. Client reports auditory hallucinations
- C. Moves quickly from one idea to the next
- D. Client expresses illusions of grandeur
Correct Answer: A
Rationale: The correct answer is A: Inability to carry out a simple task. During a depressive episode in bipolar disorder, individuals often experience cognitive impairment, including difficulty concentrating and making decisions. This can lead to an inability to carry out simple tasks. Choices B, C, and D are more indicative of symptoms seen in manic episodes, such as auditory hallucinations (B), racing thoughts (C), and grandiosity (D). By understanding the characteristic symptoms of bipolar disorder episodes, the nurse can appropriately assess and provide interventions for the client.
A client with schizophrenia is prescribed risperidone. Which of the following should the nurse monitor for as an adverse effect of this medication?
- A. Increased blood pressure
- B. Weight gain
- C. Excessive salivation
- D. Bradycardia
Correct Answer: B
Rationale: The correct answer is B: Weight gain. Risperidone is an antipsychotic medication known to cause metabolic side effects such as weight gain. This is due to its impact on appetite regulation and metabolism. Monitoring weight is crucial to prevent complications such as diabetes and cardiovascular issues.
A: Increased blood pressure is not a common adverse effect of risperidone.
C: Excessive salivation is not a typical side effect of risperidone.
D: Bradycardia is not associated with risperidone use in clients with schizophrenia.
A nurse is admitting a client who has dementia to a long-term care facility. The client tells the nurse that she lived in this facility years ago and took care of all the residents by herself. The nurse should document this as which of the following findings?
- A. Projection
- B. Perseveration
- C. Agnosia
- D. Confabulation
Correct Answer: D
Rationale: The correct answer is D: Confabulation. Confabulation is the creation of false memories to fill in gaps in memory due to brain dysfunction. In this scenario, the client with dementia is creating a false memory about living in the facility and taking care of all the residents by herself. This is a common phenomenon in individuals with dementia as their ability to recall accurate memories is impaired.
A: Projection is a defense mechanism where one attributes their own feelings or thoughts to others.
B: Perseveration is the repetition of a particular response despite the absence or cessation of a stimulus.
C: Agnosia is the inability to recognize or interpret sensory information.
Summary: The other choices are incorrect because they do not specifically address the creation of false memories to compensate for memory deficits, which is characteristic of confabulation in individuals with dementia.
A nurse in an acute care mental health facility is placing a client in seclusion and restraints. Which of the following actions should the nurse plan to take?
- A. Ensure that the prescription for restraints be renewed every 6 hr.
- B. Document the client's behavior every 15 min.
- C. Request a provider to evaluate the client in person every 36 hr.
- D. Plan to monitor the client every 30 min while restrained.
Correct Answer: B
Rationale: The correct answer is B: Document the client's behavior every 15 min. This action is important to ensure the client's safety and monitor their response to seclusion and restraints. Documenting behavior every 15 minutes allows the nurse to track changes, identify any signs of distress, and ensure the client's well-being. It also helps in providing a detailed record of the client's condition for further evaluation and decision-making.
The other choices are incorrect because:
A: Ensuring the prescription for restraints be renewed every 6 hr is not necessary for immediate monitoring and safety.
C: Requesting a provider to evaluate the client in person every 36 hr is not frequent enough for close monitoring and intervention.
D: Planning to monitor the client every 30 min while restrained is not as frequent as every 15 minutes, which may miss important changes in behavior or condition.
A nurse in an acute mental health care facility is prioritizing care for multiple clients. Which of the following clients should the nurse see first?
- A. A client who has narcissistic personality disorder and is mocking others during group therapy
- B. A client who has obsessive-compulsive disorder and is upset about a change in daily routine
- C. A client who has depressive disorder and requires assistance with ADLs
- D. A client who is taking clozapine to treat schizophrenia and reports a sore throat
Correct Answer: D
Rationale: The correct answer is D. The nurse should see the client taking clozapine first due to the potential side effect of agranulocytosis, which can manifest as a sore throat. This is a serious adverse effect that requires immediate attention to prevent complications. The other clients do not present with urgent or life-threatening issues. A: Narcissistic behavior is disruptive but not a medical emergency. B: Upset about a routine change is distressing but does not pose a physical health risk. C: Assistance with ADLs is important but not immediately life-threatening. Therefore, prioritizing the client on clozapine with a sore throat is crucial to ensure timely intervention and prevent serious complications.