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A nurse is providing teaching to a client who has panic disorder and is receiving alprazolam. Which of the following instructions should the nurse include?
- A. Take the medication on an empty stomach
- B. Avoid activities that require alertness
- C. Stop taking the medication if dizziness occurs
- D. Take an additional dose if anxiety increases
Correct Answer: B
Rationale: The correct answer is B: Avoid activities that require alertness. This is important because alprazolam is a benzodiazepine that can cause drowsiness and impair cognitive function. By avoiding activities that require alertness, the client can prevent accidents or injuries.
A: Taking the medication on an empty stomach is not necessary for alprazolam.
C: Stopping the medication if dizziness occurs is not recommended without consulting a healthcare provider.
D: Taking an additional dose if anxiety increases can lead to overdose and is not safe.
Therefore, choice B is the most appropriate instruction to include in teaching the client with panic disorder taking alprazolam.
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A nurse is preparing to administer chlorpromazine hydrochloride 25 mg PO to an older adult client. Available is chlorpromazine hydrochloride syrup 10 mg/5 mL. How many mL should the nurse administer?
- A. 12.5
- B. 10
- C. 15
- D. 5
Correct Answer: A
Rationale: The correct answer is A: 12.5 mL. To calculate this, we first determine the total amount needed, which is 25 mg. Then, we use the concentration of the syrup, which is 10 mg/5 mL. By setting up a proportion (25 mg = x mL), we can cross multiply to find x, which equals 12.5 mL. Choice B (10 mL) is incorrect because it does not provide the full 25 mg dose. Choices C (15 mL) and D (5 mL) are incorrect as they do not align with the calculated dose based on the concentration of the syrup.
A nurse in a provider’s office is assessing a school-age child who has a spiral fracture. The parent of the child provides different accounts for the cause of the injury. Which of the following actions should the nurse take first?
- A. Request that the parent leaves the room while you interview the child
- B. Report suspected abuse to child protective services
- C. Ask the child how the injury occurred
- D. Determine the immediate safety needs of the child
Correct Answer: B
Rationale: Correct Answer: B. Report suspected abuse to child protective services.
Rationale: Reporting suspected abuse to child protective services is the first step to ensure the safety and well-being of the child. In cases of conflicting stories from the parent and the child, it is crucial to prioritize the child's safety. Child protective services can investigate further to determine the true cause of the injury and provide necessary support and protection for the child.
Summary of other choices:
A: Requesting the parent to leave the room may be necessary for further assessment, but ensuring the child's safety is the priority.
C: Asking the child how the injury occurred is important but should come after ensuring the child's immediate safety.
D: Determining the immediate safety needs of the child is crucial, but reporting suspected abuse takes precedence to address potential harm.
A nurse in an inpatient mental health facility is planning care for a client who has schizophrenia and is experiencing delusions. Which of the following interventions should the nurse include?
- A. Encourage the client to focus on reality-based topics
- B. Agree with the client’s delusional beliefs
- C. Discuss the delusions in detail
- D. Provide frequent reassurance about safety
Correct Answer: A
Rationale: The correct answer is A: Encourage the client to focus on reality-based topics. This intervention is appropriate because it helps the client ground themselves in reality and potentially reduce the intensity of their delusions. By redirecting the client's focus to reality-based topics, the nurse can help them challenge and eventually overcome their delusions. Choices B, C, and D are incorrect. Agreeing with delusional beliefs can reinforce them, discussing delusions in detail may exacerbate them, and providing frequent reassurance about safety may not address the underlying issue of delusions.
A nurse in a psychiatric unit is planning care for a client who has paranoid personality disorder. Which of the following interventions should the nurse include?
- A. Encourage group therapy participation
- B. Avoid challenging the client’s paranoid beliefs
- C. Maintain eye contact during conversations
- D. Use humor to reduce the client’s anxiety
Correct Answer: B
Rationale: The correct answer is B: Avoid challenging the client’s paranoid beliefs. This is essential because challenging the client's beliefs can lead to increased defensiveness and mistrust. Instead, the nurse should validate the client's feelings without reinforcing the delusions. Encouraging group therapy (choice A) may exacerbate paranoia by increasing feelings of being scrutinized. Maintaining eye contact (choice C) may be perceived as threatening. Using humor (choice D) could be misinterpreted and lead to further distrust.
A nurse in an inpatient mental health facility is assessing a client who has schizophrenia and is taking haloperidol. Which of the following clinical findings is the nurse’s priority?
- A. High fever
- B. Insomnia
- C. Urinary hesitancy
- D. Headache
Correct Answer: A
Rationale: The correct answer is A: High fever. The priority finding is high fever because it could indicate a potentially serious adverse reaction called neuroleptic malignant syndrome (NMS) associated with haloperidol use. NMS is a life-threatening condition characterized by fever, altered mental status, muscle rigidity, and autonomic dysfunction. Prompt recognition and treatment of NMS are crucial to prevent complications. Insomnia (B), urinary hesitancy (C), and headache (D) are common side effects of haloperidol but are not as urgent as high fever, which could signify a medical emergency.