Nokea
The Beer's List is helpful in providing the nurse with a quick reference on potential risks and benefits for which likely group of clients?
- A. Infants and children
- B. Older adults
- C. Chemically dependent
- D. Complex medical problem clients
Correct Answer: B
Rationale: Beer's criterion has been used to identify drugs that may be inappropriately prescribed, ineffective, or cause adverse drug reactions in older adult clients. The Beer's criteria are very useful and help determine risk-associated situations for older adults and specific drugs that may be problematic. Chemical dependency and complex medical problems are not a consideration.
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The client who is waiting to be transported to the operating room tells the nurse of a fear of waking up during the operation. The client is visibly upset with sweaty palms, wringing of the hands, and increased heart rate. Which is the best action to be taken by the nurse?
- A. Postpone the surgery until another day/time.
- B. Allow the family to spend time with the client.
- C. Contact chaplain services and request a visit from clergy.
- D. Stay with the client until anesthesiologist evaluates situation.
Correct Answer: D
Rationale: The primary goal for nursing management of this client is to restore comfort. The nurse should validate the client's feelings, remain present, and share concerns with the anesthesiologist. If the client's fear cannot be calmed, the surgery may need to be postponed. Allowing the client to spend time with the family may be helpful but does not address the fear of anesthesia. The presence of clergy may be calming for a client with spiritual needs. Restoring calm and comfort to the client is important prior to procedures.
While caring for an older adult client, the nurse notices the client is exhibiting increased episodes of forgetfulness, restlessness, and anxiety. Which assessment data is most significant for this client?
- A. Age at retirement
- B. Hobbies and activities
- C. Recent loss of spouse
- D. Ability to care for own ADLs
Correct Answer: C
Rationale: Determining the client has suffered the recent loss of spouse may be the cause of increased anxiety.Anxiety may manifest in the older adult as confusion or change in behavior. Loss in functioning and ability to care for own ADLs can also bring about added anxiety and concern. Age at time of retirement is not significant. Involvement in activities and hobbies can help determine the coping used to deal with stress.
Clients with obsessive-compulsive disorder (OCD) may exhibit what sign or symptom?
- A. Fear of situations in which they may capture the attention of others
- B. Delayed anxiety response
- C. Psychic numbing
- D. Performing ritualistic behaviors
Correct Answer: D
Rationale: Clients with OCD may feel compelled to perform the same act repeatedly for a specific number of times or in a prescribed sequence and acknowledge performing ritualistic behaviors. Persons with social phobia experience fear of situations in which they may capture the attention of others. Post-traumatic stress disorder (PTSD) is a condition that involves a delayed anxiety response. Initially, the affected person avoids dealing with the tragedy and detaches from others using a technique that is referred to as psychic numbing.
The nurse is caring for a client diagnosed with PTSD. The client is exhibiting withdrawal and ignoring problems and issues. The nurse recognizes this as which of the following?
- A. Social phobia
- B. Flashback
- C. Psychic numbing
- D. Guilt
Correct Answer: C
Rationale: Initially, a person diagnosed with PTSD avoids dealing with the tragedy and detaches from others using a technique termed psychic numbing. Social phobia is a fear of being in social places. Flashbacks are recurrent nightmares. Guilt may occur from emotional conflicts related to the traumatic experience.
Avoiding places or situations in which panic attacks occur is how the client with agoraphobia manages fears. Which is a common symptom of agoraphobia?
- A. Surrounding self with family and friends
- B. Avoiding strangers
- C. Avoiding feelings of anxiety
- D. Feeling safer at home
Correct Answer: D
Rationale: People with agoraphobia confine themselves to home where they feel safe. The greatest fear for a person with this disorder is having a panic attack and losing control in public. Peopleâ??family, friends, or strangersâ??are less of an issue than being able to control the location (home). Anxiety disorders such as agoraphobia do not have a logical explanation and cannot be controlled through avoiding feelings of anxiety.