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A nurse is teaching about benztropine to a client who has schizophrenia. Which of the following statements should the nurse include in the teaching?
- A. This medication is given to help with extrapyramidal side effects
- B. This medication is given to help with your depression
- C. Benztropine helps alleviate your hallucinations
- D. Benztropine is used to counteract your tachycardia
Correct Answer: A
Rationale: Correct Answer: A: This medication is given to help with extrapyramidal side effects.
Rationale:
1. Benztropine is an anticholinergic medication commonly used to manage extrapyramidal side effects (EPS) caused by antipsychotic medications.
2. EPS include symptoms like tremors, muscle stiffness, and restlessness, which can occur with antipsychotic use.
3. By blocking certain neurotransmitters in the brain, benztropine helps alleviate these side effects.
4. Other choices are incorrect:
- B: Benztropine does not treat depression, as it is not an antidepressant.
- C: Benztropine does not directly address hallucinations, which are typically managed with antipsychotic medications.
- D: Benztropine does not specifically target tachycardia, which may be a side effect of other medications but not the primary indication for benztropine use.
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A nurse is assessing a client who has histrionic personality disorder. Which of the following findings should the nurse expect?
- A. Lack of remorse
- B. Attention seeking
- C. Splitting of staff
- D. Identity disturbance
Correct Answer: B
Rationale: The correct answer is B: Attention seeking. In histrionic personality disorder, individuals often seek attention by being overly dramatic, seductive, or provocative. This behavior is a key characteristic of the disorder. Lack of remorse (A) is more indicative of antisocial personality disorder. Splitting of staff (C) is more commonly associated with borderline personality disorder. Identity disturbance (D) is a feature of borderline personality disorder as well. In summary, attention seeking behavior is a hallmark trait of histrionic personality disorder, making choice B the correct answer in this scenario.
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 caring for a client who has a lithium level of 0.8 mEq/L. Which of the following actions should the nurse take?
- A. Withhold the next dose of lithium
- B. Repeat the lithium level test
- C. Administer the next dose of lithium
- D. Recommend a low sodium diet
Correct Answer: C
Rationale: The correct answer is C: Administer the next dose of lithium. A lithium level of 0.8 mEq/L is within the therapeutic range (0.6-1.2 mEq/L), so the nurse should continue the medication as prescribed. Withholding the dose (choice A) can lead to subtherapeutic levels and ineffective treatment. Repeating the test (choice B) is unnecessary as the current level is within the therapeutic range. Recommending a low sodium diet (choice D) is not directly related to lithium therapy.
A nurse is caring for a school-aged child who has conduct disorder and is being physically aggressive toward other children in the unit. Which of the following actions should the nurse take first?
- A. Place the child in seclusion
- B. Use therapeutic hold technique
- C. Apply wrist restraints
- D. Administer risperidone
Correct Answer: A
Rationale: The correct answer is A: Place the child in seclusion. The first step in managing physically aggressive behavior in a child with conduct disorder is to ensure the safety of the child and others. Placing the child in seclusion helps prevent harm to others while allowing the child to calm down in a controlled environment. Using therapeutic hold technique (B) or applying wrist restraints (C) may escalate the situation and increase the risk of harm. Administering risperidone (D) is a medication intervention that should be considered only after addressing the immediate safety concerns.
A school nurse is caring for an adolescent client whose teacher reports changes in school performance and withdrawal from interaction with classmates. Which of the following interventions is the nurse’s priority at this time?
- A. Contact the adolescent’s parents
- B. Suggest the adolescent join support groups
- C. Ask the adolescent if he is considering hurting himself
- D. Determine when the adolescent’s change in behavior began
Correct Answer: C
Rationale: The correct answer is C: Ask the adolescent if he is considering hurting himself. This is the priority intervention because it addresses the immediate safety and well-being of the adolescent. By directly asking about thoughts of self-harm, the nurse can assess the risk of suicide and provide appropriate interventions if necessary. Contacting the parents (choice A) can be important but not the priority in this situation. Suggesting support groups (choice B) and determining when the behavior changes began (choice D) are important steps but not as urgent as assessing for suicidal ideation.