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The history of a child newly diagnosed with ADHD reveals that the child is experiencing sleeping difficulties. Which agent would the nurse most likely use?
- A. Methylphenidate
- B. Atomoxetine
- C. Bupropion
- D. Clonidine
Correct Answer: B
Rationale: The correct answer is B: Atomoxetine. Atomoxetine is the preferred agent for ADHD in children with sleeping difficulties as it does not typically affect sleep patterns. Methylphenidate (A) may worsen sleep issues due to its stimulant properties. Bupropion (C) can also cause insomnia. Clonidine (D) may help with sleep but is not the first-line choice for ADHD without comorbid conditions like tics or aggression.
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A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, the nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer?
- A. Diphenhydramine (Benadryl)
- B. Propranolol (Inderal)
- C. Risperidone (Risperdal)
- D. Aripiprazole (Abilify)
Correct Answer: A
Rationale: The correct answer is A: Diphenhydramine (Benadryl). Dystonic reactions are extrapyramidal side effects commonly seen with antipsychotic medications. Diphenhydramine is a first-line treatment for dystonic reactions due to its anticholinergic properties. It helps block the excessive dopamine activity in the brain that causes these reactions. Propranolol (B) is a beta-blocker and not typically used for dystonic reactions. Risperidone (C) and Aripiprazole (D) are antipsychotic medications themselves and would not be used to treat dystonic reactions caused by antipsychotic medications.
Which technique is most applicable to aversion therapy?
- A. Punishment
- B. Desensitization
- C. Role modeling
- D. Positive reinforcement
Correct Answer: A
Rationale: Aversion therapy aims to reduce unwanted behaviors by associating them with negative consequences. Punishment, option A, is the most applicable technique as it involves applying an unpleasant stimulus to decrease the likelihood of a behavior occurring again. Desensitization (B) and positive reinforcement (D) aim to increase desired behaviors, which is not the goal of aversion therapy. Role modeling (C) involves observing and imitating others' behaviors, which is unrelated to aversion therapy's principles.
While caring for a family, the nurse determines that first-order changes have occurred with which of the following?
- A. The children are all in school, and the parent returns to work.
- B. The daughter leaves home to attend college.
- C. The son marries his long-time sweetheart and moves into his own home.
- D. The grandmother who has been living in the household dies.
Correct Answer: A
Rationale: The correct answer is A because first-order changes refer to small, incremental adjustments within the system. In this scenario, the parent returning to work while the children are all in school signifies a gradual shift in the family dynamic. The other choices involve significant and more disruptive changes like a daughter leaving for college, a son getting married and moving out, and the death of a family member, which are considered second-order changes that lead to more substantial shifts in the family system.
A client diagnosed with complex somatic symptom disorder and depression is prescribed medication therapy to treat both the pain and the symptoms of depression. When teaching the client about the medication, which of the following would the nurse emphasize?
- A. Need for signing a no-suicide contract
- B. Avoidance of foods that contain aged cheese
- C. Use of sunscreen when exposed to bright sunlight
- D. Limiting of the amount of water ingested
Correct Answer: B
Rationale: The correct answer is B: Avoidance of foods that contain aged cheese. Aged cheese contains tyramine, which can interact with certain medications used to treat depression, such as MAOIs. This interaction can lead to a dangerous increase in blood pressure known as a hypertensive crisis. Therefore, it is crucial for the client to avoid foods high in tyramine, such as aged cheese, to prevent this potentially life-threatening reaction. Signing a no-suicide contract (choice A) is important but not directly related to medication teaching. Using sunscreen (choice C) and limiting water intake (choice D) are not relevant considerations for this medication regimen.
A client with a long history of alcohol use disorder has been diagnosed with Wernicke-Korsakoff syndrome. With which member of the mental health-care team would the nurse collaborate to meet this client's described need?
- A. The psychiatrist to obtain an order for neurocognitive disorder medications.
- B. The psychologist to set up counseling sessions to explore stressors.
- C. The dietitian to help the client increase consumption of thiamine-rich foods.
- D. The social worker to plan transportation to Alcoholics Anonymous.
Correct Answer: C
Rationale: The correct answer is C: The dietitian to help the client increase consumption of thiamine-rich foods. Wernicke-Korsakoff syndrome is caused by thiamine deficiency, commonly seen in individuals with alcohol use disorder. Thiamine supplementation is essential in managing this condition. Collaborating with a dietitian can ensure the client receives proper education and guidance on increasing thiamine intake through diet.
Incorrect choices:
A: The psychiatrist for neurocognitive disorder medications - While medications may be prescribed for symptoms, addressing the underlying thiamine deficiency is crucial.
B: The psychologist for counseling sessions - Counseling can be beneficial, but addressing the nutritional deficiency is a priority.
D: The social worker for transportation to AA - Important for ongoing support, but addressing the nutritional needs comes first to manage Wernicke-Korsakoff syndrome.