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A nurse is caring for a client who has alcohol use disorder and is experiencing withdrawal. Which of the following medications should the nurse administer?
- A. Methadone
- B. Chlordiazepoxide
- C. Naltrexone
- D. Disulfiram
Correct Answer: B
Rationale: The correct answer is B: Chlordiazepoxide. This medication is a benzodiazepine used to manage alcohol withdrawal symptoms by reducing anxiety, agitation, and preventing seizures. Benzodiazepines help to stabilize the central nervous system during alcohol withdrawal, making it the appropriate choice for this client.
Incorrect Choices:
A: Methadone is used for opioid withdrawal, not alcohol withdrawal.
C: Naltrexone is used for alcohol dependence treatment by reducing cravings, not for acute withdrawal symptoms.
D: Disulfiram is used as a deterrent for alcohol consumption, not for managing withdrawal symptoms.
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A nurse is developing a behavioral contract with a client who has antisocial personality disorder. Which of the following client goals should the nurse include in the contract?
- A. Use projection during group therapy
- B. Increase self-esteem
- C. Use bargaining skills for behavioral consequences
- D. Decrease the number of verbal outbursts
Correct Answer: D
Rationale: The correct answer is D: Decrease the number of verbal outbursts. For a client with antisocial personality disorder, managing impulsivity and aggression is crucial. Decreasing verbal outbursts helps improve social interactions and relationships. Using projection (A) can exacerbate manipulative behavior. Increasing self-esteem (B) may not address the core issues of the disorder. Using bargaining skills (C) might reinforce manipulative tendencies rather than promoting genuine change in behavior.
A nurse is caring for a client who reports that he is angry with his partner because she thinks he is just trying to gain attention. When the nurse attempts to talk to the client, he becomes angry and tells her to leave. Which of the following defense mechanisms is the client demonstrating?
- A. Rationalization
- B. Denial
- C. Compensation
- D. Displacement
Correct Answer: C
Rationale: The client is demonstrating the defense mechanism of Compensation. Compensation involves covering up weaknesses by emphasizing strengths in other areas. In this scenario, the client is compensating for feeling inadequate or unappreciated by becoming angry and defensive when his actions are questioned. This behavior serves to divert attention away from his perceived shortcomings and protect his self-esteem.
Rationalization (A) involves creating logical explanations to justify behaviors or feelings. Denial (B) is refusing to acknowledge unpleasant realities. Displacement (D) is redirecting emotions from the real target to a substitute target. In this case, these defense mechanisms are not as applicable as Compensation, which directly relates to the client's behavior of overcompensating for his perceived lack of attention.
A nurse in a mental health facility is caring for a client who has borderline personality disorder. Which of the following findings should the nurse expect?
- A. Persistent mood swings
- B. Hypersomnia
- C. Avoidance of eye contact
- D. Ritualistic behaviors
Correct Answer: A
Rationale: The correct answer is A: Persistent mood swings. Borderline personality disorder is characterized by unstable emotions, leading to frequent and intense mood swings. This is a hallmark feature of the disorder. Hypersomnia (choice B) is not typically associated with borderline personality disorder. Avoidance of eye contact (choice C) is more commonly seen in conditions like social anxiety disorder. Ritualistic behaviors (choice D) are more characteristic of obsessive-compulsive disorder, not borderline personality disorder. In summary, persistent mood swings are a key feature of borderline personality disorder, distinguishing it from the other options provided.
A nurse is reviewing laboratory values for a client who has bipolar disorder and a prescription for lithium. Which of the following laboratory results places the client at risk for lithium toxicity?
- A. Calcium 9.0 mg/dL
- B. Sodium 130 mEq/L
- C. Chloride 98 mEq/L
- D. Potassium 5.0 mEq/L
Correct Answer: B
Rationale: The correct answer is B: Sodium 130 mEq/L. Low sodium levels increase the risk of lithium toxicity as lithium competes with sodium for reabsorption in the kidneys. This can lead to higher lithium levels in the bloodstream, putting the client at risk for toxicity. The other choices (A, C, D) are within normal ranges and do not directly impact lithium toxicity. Therefore, the client with low sodium levels is at the highest risk for lithium toxicity.
A nurse is providing teaching to a client who has obsessive-compulsive disorder and engages in excessive handwashing. Which of the following instructions should the nurse include?
- A. Encourage the client to stop washing hands
- B. Allow additional time for rituals
- C. Limit ritual behaviors immediately
- D. Ignore the compulsions
Correct Answer: B
Rationale: The correct answer is B: Allow additional time for rituals. This is because abruptly stopping the handwashing rituals can lead to increased anxiety and distress for the client. Allowing additional time for rituals can help the client feel more in control and gradually work towards reducing the behavior. Encouraging the client to stop washing hands (A) abruptly can be counterproductive. Limiting ritual behaviors immediately (C) can also increase anxiety. Ignoring the compulsions (D) may worsen the condition.