Nokea
If the physician prescribes imipramine hydrochloride (Tofranil) for the client, the nurse should assess for which therapeutic drug effect first?
- A. Absence of suicidal ideation
- B. Improved concentration
- C. Decreased agitation
- D. Regulated mood
Correct Answer: D
Rationale: Regulated mood is the primary therapeutic effect of imipramine, addressing the core symptoms of depression.
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The client who sustained a brain injury from an MVA is now experiencing aggression impulsivity and poor judgment. In teaching the family which area of the brain illustrated should the nurse identify as being affected?
- A. Line A
- B. Line B
- C. Line C
- D. Line D
Correct Answer: B
Rationale: The prefrontal cortex (Line B) modulates judgment aggression and impulsivity. Cortex (A) controls motor functions hypothalamus (C) regulates temperature/fluids and cerebellum (D) manages balance. image4.png
Which nursing actions will best protect the client's safety? Select all that apply.
- A. Station a security guard outside the client's room at all times.
- B. Remove all cords, wires, and strings in the room.
- C. Provide paper dishes and plastic utensils.
- D. Assess whether the client has swallowed all medications.
- E. Ask a family member to stay with the client during the night.
- F. Check in on the client every 30 minutes.
Correct Answer: B,C,D,F
Rationale: Removing potential hazards, using safe utensils, ensuring medication compliance, and frequent checks minimize suicide risk by reducing means and monitoring behavior.
When the counselor asks the members of the post-traumatic stress disorder (PTSD) support group to draw pictures of their traumatic experiences, the nurse understands that the primary purpose for drawing is to achieve what outcome?
- A. Deal consciously with painful memories
- B. Bond with other group members
- C. Receive approval from group members
- D. Justify participation in the group
Correct Answer: A
Rationale: Drawing traumatic experiences externalizes memories, helping clients confront and process painful events in a controlled, therapeutic way.
The client experiencing severe withdrawal symptoms due to alcohol dependence is prescribed chlordiazepoxide 100 mg oral x 1 then 50 mg every 2 hours until symptoms are controlled. The medication is supplied in 50-mg tablets. The nurse administered the initial dose 2 hours ago and the client is still agitated and tremulous. How many tablets should the nurse prepare to administer at this time?_ tablet(s) (Record your answer as a whole number.)
Correct Answer: 1
Rationale: Proportion: 50 mg/1 tablet = 50 mg/X tablets; X = 1 tablet.
The client has been placed in restraints for violent behavior. Which statement best indicates the nurse’s understanding of the risk for client injury while being restrained?
- A. “Can you arrange to order the client’s favorite sandwich for his lunch?”
- B. “I need to make sure the restraints’ release mechanisms are working properly.”
- C. “I need someone to continuous monitor the client and relieve me for a few minutes.”
- D. “The client’s feet feel a little cool but they have a good pulse. I’ll get a pair of socks.”
Correct Answer: C
Rationale: Continuous monitoring (C) prevents injury during restraint. Nutrition (A) release mechanisms (B) and circulation checks (D) are secondary to constant observation.