Nokea
An adult female client is brought to the Emergency Center after fainting at work. The nurse completes an assessment of the client and identifies caregiver role strain as a nursing problem. Which information best supports this problem?
- A. Cares for an older parent and her children
- B. Anxious to leave for personal appointments
- C. Takes naps in her car during lunch hour
- D. Works an average of 60 hours per week
Correct Answer: A
Rationale: Caring for an older parent and children simultaneously indicates significant caregiver role strain due to increased responsibilities. Anxiety, napping, and long work hours suggest stress but are less specific to caregiving demands.
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Which reason(s) should the nurse expect a female client to use when she is having difficulty leaving a relationship where she is a victim of intimate partner violence? Select all that apply.
- A. Shame and guilt
- B. Children
- C. Religious beliefs about marriage
- D. The perpetrator will not change
- E. Financial dependency
Correct Answer: A,B,C,E
Rationale: A: Shame and guilt can prevent leaving due to fear of judgment. B: Children influence staying for their well-being or custody concerns. C: Religious beliefs about marriage may emphasize staying. E: Financial dependency is a common barrier. D: Belief the perpetrator won't change is not a reason to stay but rather a reason to leave.
A client who is an alcoholic receives a prescription for disulfiram 500 mg by mouth (PO) daily. Which instruction should the nurse provide to this client?
- A. Take the medication at bedtime and avoid consuming any more than one ounce of alcohol
- B. Take the medication with at least 8 ounces (240 mL) of water and limit alcohol consumption while taking this medication
- C. Begin taking the medication immediately and take it daily, regardless of whether or not you drink alcohol
- D. Take the medication each morning beginning 48 hours after your last drink of alcohol
Correct Answer: D
Rationale: Disulfiram must be started at least 48 hours after the last alcohol intake to prevent severe reactions, and alcohol must be completely avoided. Options A and B incorrectly suggest limited alcohol is safe. Option C risks reactions if alcohol is still in the system.
The nurse continues caring for the client:
The client is a 26-year-old female who was in a car accident 6 months s ago that killed her mother, husband, and 2-year-old son. She and her father were the only survivors of the crash. She is seeking care for depression.
Click to indicate whether findings at the next follow-up appointment indicate that the treatment was effective or ineffective. Each row must have one response selected.
- A. The client talks to her father and her best friend when she starts to feel sad: Effective
- B. The client states she feels numb when thinking about the crash: Ineffective
- C. The client states that she avoids driving altogether and takes the bus: Effective
- D. The client reports sleeping 6 to 7 hours per night: Effective
- E. The client states she feels less jumpy and more relaxed: Effective
Correct Answer: A,B,C,D,E
Rationale: A: Seeking support is a positive coping mechanism (Effective). B: Numbness suggests unresolved trauma (Ineffective). C: Avoiding driving reduces distress (Effective). D: Adequate sleep indicates improvement (Effective). E: Reduced anxiety shows treatment efficacy (Effective).
During a family group meeting, the client's daughter tells the group, 'I hope I didn't cause Mom to be depressed.' Which response is best for the nurse to provide?
- A. I hear you say you worry about causing your mother's distress
- B. Are you afraid that your mother's depression will lead to her death?
- C. What do you think you did that led to your mother's depression?
- D. You are not alone in feeling responsible for others in your family
- E. You are not alone in feeling responsible for others in your family
Correct Answer: A
Rationale: This response acknowledges the daughter's feelings without assumptions or blame, fostering open communication. The second option escalates anxiety. The third may encourage self-blame. The fourth generalizes without addressing her specific concern.
The nurse is performing intake interviews at a psychiatric clinic. A client with a known history of drug abuse reports having had a heart attack four years ago. Use of which substance places the client at highest risk for myocardial infarction?
- A. Alcohol
- B. Benzodiazepine
- C. Methamphetamine
- D. Marijuana
Correct Answer: C
Rationale: Methamphetamine use is known to cause significant cardiovascular effects, including increased heart rate, blood pressure, and vasoconstriction, which can lead to myocardial infarction. Excessive alcohol consumption can contribute to cardiovascular issues but is less potent than methamphetamine. Benzodiazepines primarily affect the central nervous system, not the cardiovascular system. Marijuana has cardiovascular effects but is generally less risky than methamphetamine.