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An elderly patient brings a bag of medications to the clinic. The nurse finds a bottle labeled Ativan and one labeled lorazepam, both of which are to be taken BID. There are also bottles labeled hydrochlorothiazide, Inderal, and rofecoxib, each to be taken once daily. Which conclusion is accurate?
- A. Rofecoxib should not be taken with Ativan
- B. Lorazepam and Ativan are the same drug, so the dose is excessive.
- C. Lorazepam interferes with the action of Inderal.
- D. The patient should not self-administer medication.
Correct Answer: B
Rationale: Ativan and lorazepam are the same drug, so the patient is taking an excessive dose of lorazepam. This requires intervention by the nurse to prevent harm.
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An advanced practice nurse is qualified to perform which action for patients?
- A. Perform mental health assessment interviews.
- B. Prescribe psychotropic medication.
- C. Establish therapeutic relationships.
- D. Individualize nursing care plans.
Correct Answer: B
Rationale: Advanced practice nurses, such as psychiatric-mental health nurse practitioners, are qualified to prescribe medications, including psychotropics, as part of their expanded scope of practice. Other listed actions can also be performed by registered nurses.
By discharge, which outcome is appropriate for a patient who hears voices telling them they are evil?
- A. Respond verbally to the voices.
- B. Verbalize the reason the voices say they are evil
- C. Identify events that increase anxiety and promote hallucinations.
- D. Integrate the voices into their personality structure in a positive manner.
Correct Answer: C
Rationale: Identifying triggers for hallucinations is a key step in managing symptoms effectively
Which statement made by a teenage male hospitalized after a failed suicide attempt is most concerning to the nurse?
- A. The gun I got for my birthday is my most prized possession.
- B. I don’t know why I get so depressed and want to die.
- C. "I don’t feel like I can talk to anyone about my feelings."
- D. The gun I got for my birthday is my most prized possession.
Correct Answer: D
Rationale: This statement is concerning because it suggests the teenager may still have access to dangerous means (in this case, a gun) and may not fully understand or take responsibility for the gravity of his previous suicidal attempt. The attachment to the gun is alarming.
A patient is being seen for symptoms of insomnia and significant weight loss that has occurred during the 2 months since her husband’s death. What is the purpose of the query, “Describe how it has been for you since your husband died?”
- A. To display an attitude of concern and sympathy to the patient
- B. To learn whether the patient has a significant support system
- C. To rule out factors that may interfere with diagnosing her illness
- D. To determine the risk for pathologic grief and the need for grief therapy
Correct Answer: D
Rationale: The purpose of the query "Describe how it has been for you since your husband died?" is to determine the risk for pathologic grief and the need for grief therapy. The patient is experiencing symptoms of insomnia and significant weight loss following her husband's death, which could indicate complicated or pathologic grief. By asking this open-ended question, the healthcare provider can gain insight into the patient's emotional well-being, coping mechanisms, and overall adjustment to the loss. The response can help assess whether the patient might benefit from additional support or interventions, such as grief therapy, to help her navigate through the grieving process in a healthy manner. It is essential to identify and address any potential complications related to grieving to provide appropriate care and support to the patient.
In a sad voice, an elderly patient tells the nurse of the recent deaths of a spouse and close friend. The patient has no other family and only a few acquaintances in the community. The nurse’s priority is to determine whether which nursing diagnosis applies to this patient?
- A. Risk for suicide related to recent deaths of significant others.
- B. Anxiety related to sudden and abrupt lifestyle changes.
- C. Social isolation related to loss of existing family
- D. Spiritual distress related to anger with God.
Correct Answer: A
Rationale: The patient’s sadness and recent significant losses (spouse and friend) put them at risk for depression and suicidal ideation. The nurse should assess for suicidal thoughts and behaviors.