Nokea
A patient is being seen in the crisis unit reporting that poison letters are coming in the mail. The patient has no history of psychiatric illness. Which group of the following medications would the patient most likely be started on?
- A. Aripiprazole (Abilify)
- B. Risperidone (Risperdal Consta)
- C. Fluphenazine (Prolixin)
- D. Fluoxetine (Prozac)
Correct Answer: A
Rationale: The correct answer is A: Aripiprazole (Abilify). In this scenario, the patient is experiencing paranoid delusions, a symptom commonly associated with psychotic disorders. Aripiprazole is an atypical antipsychotic that is often used to treat symptoms of psychosis, including delusions. It is a preferred choice because it has a lower risk of side effects compared to typical antipsychotics like fluphenazine. Risperidone, another atypical antipsychotic, could also be considered, but aripiprazole is often preferred due to its side effect profile. Fluoxetine, an antidepressant, is not the ideal choice for treating psychotic symptoms. Therefore, aripiprazole is the most appropriate medication in this case.
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Mr. K is admitted to the orthopedic unit one morning in preparation for a total knee replacement to start in two hours. Which of the following is a priority topic to instruct this client on admission?
- A. The approximate length of the surgery
- B. The type of anticoagulants that will be prescribed
- C. The time of the next meal of solid food
- D. The length of time until the client can return to work
Correct Answer: A
Rationale: The correct answer is A: The approximate length of the surgery. This is the priority topic to instruct the client on admission because knowing the duration of the surgery helps manage the client's expectations and anxiety levels. Understanding the length of the procedure also allows the client to plan for post-operative care and recovery.
Choice B: The type of anticoagulants is important but not as critical on admission as knowing the surgery duration. Choice C: The time of the next meal is important for preoperative fasting but not as crucial as understanding the surgery length. Choice D: The length of time until the client can return to work is important, but it is a secondary concern compared to the immediate surgical procedure.
Which of the following clients is most likely ready to be dismissed from an inpatient care setting to home?
- A. A 65-year old male with urine output of 60cc in the past four hours
- B. A 2-month old female with a temperature of 100.6 rectally
- C. A 38-year old female who transitioned from IV TPN to full liquids six hours ago
- D. A 4-year old male with an oxygen saturation of 96% on room air
Correct Answer: D
Rationale: The correct answer is D because an oxygen saturation of 96% on room air indicates adequate oxygenation, suggesting the client is stable and can be discharged home. A: Low urine output may indicate dehydration or kidney issues, requiring further monitoring. B: A fever in an infant warrants evaluation for infection, not ready for discharge. C: Recent transition from IV TPN to full liquids may require ongoing monitoring for tolerance and nutritional status.
A nurse is required to float to another unit within the hospital where he is asked to care for a client on a ventilator. The nurse is uncomfortable with this assignment, as he has not had a ventilated client since nursing school. What is the nurse's most appropriate response?
- A. Explain to the nursing supervisor the level of discomfort and ask for a different assignment
- B. State that the client's needs are outside the nurse's scope of practice and request a different assignment
- C. Accept the assignment, asking for help when necessary
- D. Request to return to the home unit and send another nurse who can perform the job
Correct Answer: A
Rationale: The correct answer is A: Explain to the nursing supervisor the level of discomfort and ask for a different assignment. This is the most appropriate response because the nurse is being transparent about their discomfort and seeking a solution to ensure quality care for the client. By communicating concerns, the nurse can potentially be given a more suitable assignment or receive additional training. Option B is incorrect as it is important for nurses to continuously learn and adapt to new situations within their scope of practice. Option C is not ideal as the nurse should not take on a task they are uncomfortable with without proper support. Option D is not the best choice as it does not address the issue directly with the supervisor.
In which situation might an occupational health nurse consultation be necessary?
- A. A nurse is injured from using incorrect body mechanics to lift a client
- B. A nurse receives a subpoena to testify in court about a client's case
- C. A client who has been injured in a diving accident needs assistance with planning rehabilitation and surgery
- D. A nursing unit is implementing a new electronic health record system
Correct Answer: A
Rationale: The correct answer is A: A nurse is injured from using incorrect body mechanics to lift a client. Occupational health nurse consultation would be necessary in this situation to assess the nurse's injury, provide appropriate care, and prevent future injuries. This aligns with the role of occupational health nurses in promoting workplace safety and employee health.
Choice B is incorrect because receiving a subpoena to testify in court does not directly relate to the need for an occupational health nurse consultation.
Choice C is incorrect as it involves the client needing assistance with rehabilitation and surgery, which would typically involve medical professionals other than occupational health nurses.
Choice D is also incorrect as implementing a new electronic health record system does not necessitate an occupational health nurse consultation.
A patient diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. Treatment most likely provided by the center includes
- A. Medical management of symptoms
- B. Daily psychotherapy
- C. Constant staff supervision
- D. Psychological stabilization
Correct Answer: A
Rationale: The correct answer is A: Medical management of symptoms. In mild anxiety disorders, medication like SSRIs or benzodiazepines are commonly used to alleviate symptoms. Psychotherapy may be helpful but is not daily. Constant staff supervision is not necessary for mild cases. Psychological stabilization is too broad and not specific to treatment.