Nokea
A nurse is caring for several clients who have mental health disorders at an assisted-living facility. Which of the following clients should the nurse determine needs to be seen by a provider immediately?
- A. A client who is taking olanzapine and experiences dizziness when first standing up
- B. A client who is taking chlorpromazine and reports vomiting twice
- C. A client who is taking thioridazine and has daytime drowsiness
- D. A client who is taking clozapine and has flu-like manifestations
Correct Answer: D
Rationale: The correct answer is D. Clozapine is associated with a serious side effect called agranulocytosis, which can manifest as flu-like symptoms such as fever, sore throat, and malaise. Agranulocytosis is a potentially life-threatening condition that requires immediate medical attention to prevent complications. Clients taking clozapine should be monitored closely for signs of infection. Choices A, B, and C describe common side effects of antipsychotic medications that are not typically considered emergencies. For example, dizziness upon standing (A), vomiting (B), and daytime drowsiness (C) are known side effects that may not require immediate medical attention unless severe or persistent. Therefore, the client taking clozapine with flu-like manifestations (D) should be seen by a provider immediately due to the potential seriousness of agranulocytosis.
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A nurse is providing discharge teaching for a client who has multiple medication prescriptions and must take the medications at specific intervals when at home. Which of the following instructions should the nurse include in the teaching?
- A. "You really shouldn't change the schedule we established here in the facility."
- B. "Let's work together to devise a time schedule that is convenient for you on a daily basis."
- C. "I'll have to talk to your provider about switching to an alternative schedule."
- D. "It doesn't really matter what time you take your medications as long as you don't skip any doses."
Correct Answer: B
Rationale: The correct answer is B. By working together to devise a time schedule convenient for the client, the nurse ensures medication adherence. This approach promotes patient autonomy and empowerment, increasing the likelihood of compliance. Choice A is incorrect as it disregards the client's needs. Choice C involves unnecessary steps and may delay important changes. Choice D is incorrect as adherence to specific timing is crucial for some medications. Choices E, F, and G are omitted due to irrelevance.
A nurse is preparing to teach a client about his prescription of lithium for the treatment of bipolar disorder. Which of the following statements should the nurse include in the teaching?
- A. "You will need to consume a low-salt diet while on this medication."
- B. "You will need your blood levels drawn weekly during the first month."
- C. "You will need to take this medication on an empty stomach."
- D. "You will need to stop this medication if you experience diarrhea."
Correct Answer: B
Rationale: Lithium levels need frequent monitoring at the start of therapy to prevent toxicity.
A nurse in an acute care mental health facility is preparing to administer morning medication for a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following actions should the nurse take?
- A. Prepare for gastric lavage due to an extremely elevated lithium level.
- B. Administer the morning dose of lithium.
- C. Check the client's medication record to assess whether the client has been refusing her lithium.
- D. Hold the medication and assess for early manifestations of toxicity.
Correct Answer: B
Rationale: A lithium level of 1.0 mEq/L is within the therapeutic range (0.6-1.2 mEq/L).
A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? (Select all that apply.)
- A. Urinary retention and constipation
- B. Tongue thrusting and lip smacking
- C. Fine hand tremors and pill rolling
- D. Facial grimacing and eye blinking
- E. Involuntary pelvic rocking and hip thrusting movements
Correct Answer: B, D, E
Rationale: Tardive dyskinesia involves involuntary repetitive movements such as lip smacking, facial grimacing, and pelvic rocking.
A nurse is teaching a group of nursing students about ageism. Which of the following statements should the nurse include?
- A. "Ageism refers to a higher level of respect that Eastern cultures give to their elders."
- B. "Ageism refers to the stereotype that older adults are not able to understand new information."
- C. "Ageism refers to assumptions about an older adult client based on gender and economic status."
- D. "Ageism refers to the increase in physical care required by older adults."
Correct Answer: B
Rationale: Ageism involves stereotypes that portray older adults as cognitively incapable.