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A nurse is evaluating the medication response of a client who takes naltrexone for the treatment of alcohol use disorder. The nurse should identify that which of the following is a therapeutic effect of this medication.
- A. Blocks aldehyde dehydrogenase
- B. Prevents the anxiety of abstinence
- C. Reduces substance craving
- D. Decreases the likelihood of seizures
Correct Answer: C
Rationale: The correct answer is C: Reduces substance craving. Naltrexone is an opioid receptor antagonist that helps reduce the craving for alcohol by blocking the euphoric effects associated with alcohol consumption. This medication does not block aldehyde dehydrogenase (choice A), which is involved in alcohol metabolism. It also does not prevent the anxiety of abstinence (choice B) or decrease the likelihood of seizures (choice D). Naltrexone specifically targets reducing the desire to drink, making choice C the most appropriate therapeutic effect in this scenario.
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A nurse is assessing a client who has opioid intoxication. Which of the following findings should the nurse expect?
- A. Pinpoint pupils
- B. Hyperreflexia
- C. Increased respiratory rate
- D. Dilated pupils
Correct Answer: A
Rationale: The correct answer is A: Pinpoint pupils. Opioid intoxication causes miosis, resulting in constricted or pinpoint pupils. This occurs due to the suppression of the sympathetic nervous system. Hyperreflexia (B) is not typically associated with opioid intoxication; it is more common in conditions like spinal cord injury. Opioids depress the respiratory system, leading to decreased respiratory rate (C), not increased. Dilated pupils (D) are more indicative of stimulant intoxication, such as amphetamines.
A nurse is reviewing laboratory findings for a client who has been taking lithium for 6 months. Which of the following findings should the nurse report to the provider?
- A. Lithium level 0.8 mEq/L
- B. Sodium 130 mEq/L
- C. Creatinine 1.5 mg/dL
- D. WBC 8,000/mm³
Correct Answer: C
Rationale: The correct answer is C: Creatinine 1.5 mg/dL. This finding should be reported because an elevated creatinine level indicates impaired kidney function, which can lead to lithium toxicity. Lithium is primarily excreted by the kidneys, and impaired renal function can result in lithium accumulation in the body, increasing the risk of adverse effects. Reporting this finding promptly will allow the provider to adjust the dosage of lithium to prevent toxicity.
Choices A, B, and D are within normal ranges and do not directly indicate lithium toxicity. A lithium level of 0.8 mEq/L is within the therapeutic range (0.6-1.2 mEq/L). Sodium level of 130 mEq/L is also within normal limits. WBC count of 8,000/mm³ is normal and not directly related to lithium toxicity. Therefore, these findings do not require immediate reporting compared to the elevated creatinine level.
A nurse is planning care for a client who has schizophrenia and is experiencing auditory hallucinations. Which of the following interventions should the nurse include?
- A. Encourage the client to listen to loud music
- B. Ask the client directly about the content of the hallucinations
- C. Instruct the client to ignore the voices
- D. Avoid discussing the hallucinations with the client
Correct Answer: B
Rationale: The correct answer is B: Ask the client directly about the content of the hallucinations. This intervention is important as it helps the nurse understand the nature and content of the hallucinations, allowing for better assessment and tailored intervention. By directly asking the client, the nurse can gather valuable information to provide appropriate care and support. Encouraging the client to listen to loud music (A) may exacerbate the hallucinations. Instructing the client to ignore the voices (C) may not be effective and could lead to increased distress. Avoiding discussing the hallucinations with the client (D) hinders the therapeutic communication and understanding of the client's experience.
A nurse is creating a plan of care for a client who has major depressive disorder. Which of the following interventions should the nurse include in the plan?
- A. Discourage the client from expressing feelings of anger
- B. Identify and schedule alternative group activities for the client
- C. Encourage physical activity for the client during the day
- D. Keep a bright light on in the clients room at night
Correct Answer: C
Rationale: The correct answer is C: Encourage physical activity for the client during the day. Physical activity has been shown to improve mood and reduce symptoms of depression by increasing endorphins. This intervention can help the client combat feelings of sadness and hopelessness.
A: Discouraging the client from expressing feelings of anger is not therapeutic and may further suppress emotions, worsening depression.
B: Identifying and scheduling alternative group activities can be helpful, but it may not directly address the physical aspect of depression.
D: Keeping a bright light on in the client's room at night may disrupt sleep patterns and is not a targeted intervention for major depressive disorder.
A nurse is leading a grief support group for bereaved clients. Which of the following client statements should the nurse report to the provider as an indication of clinical depression?
- A. I don’t know how I could cope if I didn’t have my family’s support
- B. It’ll be a long time before I’m happy again
- C. I don’t feel anything but numbness anymore
- D. I feel like I’m angry at the whole world right now
Correct Answer: C
Rationale: The correct answer is C: "I don’t feel anything but numbness anymore." This statement indicates a significant emotional numbness, which is a common symptom of clinical depression. It suggests a lack of normal emotional responses, which can be concerning.
Choice A does not specifically indicate clinical depression but rather expresses a need for support. Choice B reflects a natural response to grief and does not necessarily indicate depression. Choice D suggests anger, which can also be a normal part of the grieving process.
In summary, Choice C is the correct answer as it directly points to a key symptom of clinical depression, while the other choices reflect common emotional responses to grief that may not necessarily indicate depression.