During initial assessment of the teenager, what information is most important for the nurse to obtain from the parents?
- A. If he has seemed depressed recently.
- B. If a drug overdose has ever occurred before.
- C. If he might have taken any other drugs.
- D. If he has a desire to quit taking drugs.
Correct Answer: C
Rationale: The correct answer is C. It's crucial to determine if the teenager might have taken other substances besides the pain pills mentioned by the mother. This information is vital for effective treatment because knowing the full scope of substances involved helps in managing potential interactions, side effects, and the overall condition of the patient. Options A, B, and D are not as critical in the immediate assessment compared to knowing if the teenager has ingested any other drugs.
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An LPN/LVN is conducting an initial assessment on a client in crisis. When assessing the client's perception of the precipitating event that led to the crisis, the appropriate question to ask is:
- A. With whom do you live?
- B. Who is available to help you?
- C. What leads you to seek help now?
- D. What do you usually do to feel better?
Correct Answer: C
Rationale: The correct question to ask when assessing a client's perception of the precipitating event that led to a crisis is 'What leads you to seek help now?' This question directly addresses the client's current situation and triggers that brought them to seek assistance. Choices A and B are more focused on the client's social support system rather than the root cause of the crisis. Choice D addresses coping mechanisms rather than the actual trigger for seeking help.
A client is admitted to a medical nursing unit with a diagnosis of acute blindness. Many tests are performed, and there seems to be no organic reason why this client cannot see. The client became blind after witnessing a hit-and-run car accident, when a family of three was killed. A LPN/LVN suspects that the client may be experiencing a:
- A. Psychosis
- B. Repression
- C. Conversion Disorder
- D. Dissociative Disorder
Correct Answer: C
Rationale: In this scenario, the client's acute blindness without any organic cause following a traumatic event indicates a case of Conversion Disorder. Conversion Disorder involves the manifestation of physical symptoms due to psychological stressors. Psychosis (choice A) involves a loss of contact with reality, which is not evident here. Repression (choice B) is a defense mechanism that involves unconsciously blocking out thoughts. Dissociative Disorder (choice D) involves disruptions in memory, awareness, identity, or perception, which is not the primary issue in this case.
A client who is diagnosed with schizophrenia is admitted to the hospital. The nurse assesses the client's mental status. Which assessment finding is most characteristic of a client with schizophrenia?
- A. Mood swings.
- B. Extreme sadness.
- C. Manipulative behavior.
- D. Flat affect.
Correct Answer: D
Rationale: The correct answer is D: Flat affect. Flat affect, which is a lack of emotional expression, is highly characteristic of schizophrenia. Mood swings (choice A) are more indicative of mood disorders rather than schizophrenia. Extreme sadness (choice B) could be seen in depression but is not as specific to schizophrenia. Manipulative behavior (choice C) is not a defining characteristic of schizophrenia; it may be seen in various psychiatric conditions but is not the most characteristic feature of schizophrenia.
A client is being successfully treated with clozapine (Clozaril). Which of the following statements by the client reflects a need for further teaching about managing the drug's adverse effects?
- A. If I eat too many fruits, I'll get constipated.
- B. I need to take the medicine with food to avoid nausea.
- C. I have to get up slowly so I don't get dizzy.
- D. Sometimes I have to push myself because I'm sleepy.
Correct Answer: A
Rationale: Choice A reflects a need for further teaching as the client mistakenly believes that eating too many fruits causes constipation, showing a misunderstanding about dietary fiber's role in preventing constipation. Choices B, C, and D demonstrate accurate understanding of managing clozapine's adverse effects, such as taking it with food to avoid nausea, getting up slowly to prevent dizziness, and pushing oneself when feeling sleepy.
A LPN/LVN is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine (Prozac). What information would be important for the nurse to obtain during this client visit regarding the side effects of the medication?
- A. Cardiovascular symptoms
- B. Gastrointestinal dysfunctions
- C. Problems with mouth dryness
- D. Problems with excessive sweating
Correct Answer: B
Rationale: The correct answer is B: 'Gastrointestinal dysfunctions.' Fluoxetine commonly causes gastrointestinal side effects such as nausea, diarrhea, or constipation. These symptoms can significantly impact the client's quality of life and adherence to the medication regimen. Monitoring gastrointestinal issues is crucial for the nurse to ensure the client's well-being and optimize treatment outcomes. Choices A, C, and D are incorrect because cardiovascular symptoms, problems with mouth dryness, and problems with excessive sweating are not typically associated with fluoxetine use and are less likely to be a focus of concern during this client visit.