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In what order should the following goals be approached for a client being treated for alcoholism?
- A. Learning about dependence and recovery; abstinence and development of a support system; attaining physiological stabilization; developing alternative coping skills
- B. Developing alternative coping skills; attaining physiological stabilization; learning about dependence and recovery; abstinence and development of a support system
- C. Abstinence and development of a support system; attaining physiological stabilization; learning about dependence and recovery; developing alternative coping skills
- D. Abstinence and development of a support system; learning about dependence and recovery; attaining physiological stabilization; developing alternative coping skills
Correct Answer: B
Rationale: When treating a client for alcoholism, it is important to follow a structured approach to maximize treatment effectiveness. The correct order of approaching goals is to first help the client in developing alternative coping skills to manage triggers and stressors without relying on alcohol. This is followed by attaining physiological stabilization, which involves addressing any physical health issues related to alcoholism. Next, the client should learn about dependence and recovery to understand the nature of their condition and the process of recovery. Finally, the goals of abstinence and developing a support system come into play to ensure long-term sobriety and a reliable network of support. Therefore, the correct order is: Developing alternative coping skills; attaining physiological stabilization; learning about dependence and recovery; abstinence and development of a support system.
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A client has been taking lithium for several years with good symptom control. The client presents in the emergency department with blurred vision, tinnitus, and severe diarrhea. Which lithium level should the nurse correlate with these symptoms?
- A. 3.7
- B. 1.7
- C. 2.6
- D. 1.3
Correct Answer: B
Rationale: Symptoms such as blurred vision, tinnitus, and severe diarrhea are indicative of lithium toxicity. A lithium level of 1.7 is within the toxic range. When clients present with these symptoms, it is crucial for the nurse to correlate them with elevated lithium levels to ensure timely intervention and prevent further complications.
While auditing care plans for clients with eating disorders, the nurse realizes that a nursing diagnosis appropriate for a client with anorexia nervosa as well as for a client with bulimia nervosa is
- A. Risk for imbalanced body temperature
- B. Ineffective denial
- C. Chronic low self-esteem
- D. Adult failure to thrive
Correct Answer: C
Rationale: Chronic low self-esteem is a nursing diagnosis that can be applicable to clients with both anorexia nervosa and bulimia nervosa. These eating disorders are often associated with distorted body image, feelings of inadequacy, and low self-esteem. Clients with these conditions may engage in harmful behaviors related to their self-image, making chronic low self-esteem a relevant nursing diagnosis for them.
In what significant way should the therapeutic environment differ for a client who has ingested LSD from that of a client who has ingested PCP?
- A. For LSD ingestion, maintain a regimen of limited interaction and minimal verbal stimulation. For PCP ingestion, place client on one-on-one intensive supervision.
- B. For LSD ingestion, place the client in restraints. For PCP ingestion, place the client on seizure precautions.
- C. For LSD ingestion, provide continual medieval simulation involving as many senses as possible. For PCP ingestion, provide continual high-level stimulation.
- D. For PCP ingestion, place the client on one-on-one intensive supervision. For LSD ingestion, maintain a regimen of limited interaction and minimal verbal stimulation.
Correct Answer: D
Rationale: When managing a client who has ingested PCP, it is crucial to provide one-on-one intensive supervision to ensure their safety and prevent any harm to themselves or others. This level of supervision is necessary due to the unpredictable and potentially dangerous effects of PCP. On the other hand, for a client who has ingested LSD, it is recommended to maintain a calm environment with limited interaction and minimal verbal stimulation. This approach aims to prevent exacerbating any adverse effects of LSD, such as anxiety or paranoia, by reducing external stimuli. Therefore, the correct approach is to provide one-on-one intensive supervision for PCP ingestion and limit interaction and verbal stimulation for LSD ingestion.
Which medication would the nurse least likely use to provide immediate intervention for an angry psychotic client?
- A. Lithium
- B. Alprazolam
- C. Diphenhydramine
- D. Haloperidol
Correct Answer: B
Rationale: Alprazolam is a benzodiazepine commonly used for anxiety disorders. While it may help calm an individual, it is not typically the first-line choice for managing acute agitation in a psychotic client. Haloperidol, on the other hand, is a typical antipsychotic medication often used for immediate intervention in psychiatric emergencies involving aggression or psychosis.
Before discharge from the chemical dependency unit, clients are introduced to different community resources. Which of the following resources would be best for a teenage client, who has been abusing over-the-counter sedatives and is ready for discharge in two days?
- A. Detoxification center
- B. Home care
- C. Assertive community team
- D. Twelve-step recovery group
Correct Answer: A
Rationale: For a teenage client who has been abusing over-the-counter sedatives and is ready for discharge in two days, the best resource would be a detoxification center. This specialized facility can provide the necessary medical and psychological support to safely manage the withdrawal symptoms associated with substance abuse. It is crucial to ensure a safe and supervised detox process for the client's well-being and successful recovery.