Nokea
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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Which statement shows a nurse has empathy for a patient who made a suicide attempt?
- A. "You must have been very upset when you tried to hurt yourself."
- B. "It makes me sad to see you going through such a difficult experience."
- C. "If you tell me what is troubling you, I can help you solve your problems."
- D. "Suicide is a drastic solution to a problem that may not be such a serious matter."
Correct Answer: A
Rationale: The correct answer is A because it directly acknowledges the patient's emotions and perspective without judgment. It shows understanding and validation of the patient's feelings, indicating empathy. Choice B focuses on the nurse's feelings, not the patient's. Choice C offers a solution without addressing the patient's emotional state. Choice D minimizes the seriousness of the patient's situation and lacks empathy. Overall, choice A demonstrates the most empathetic response by recognizing and empathizing with the patient's emotional distress.
Based on assessment data, the nurse formulates the nursing diagnosis for a patient as sleep pattern disturbance. After teaching the patient how to relax before bedtime, the nurse determines that the teaching was effective by which outcome?
- A. Discusses feelings about not being able to fall asleep
- B. Reports feeling rested on awakening in the morning within 3 days
- C. Requests sleeping medication each night before bedtime
- D. Is able to sleep for short intervals throughout the night
Correct Answer: B
Rationale: The correct answer is B because feeling rested upon awakening indicates improved sleep quality, reflecting effective teaching on relaxation techniques. Choice A does not directly measure the effectiveness of the teaching intervention. Choice C indicates reliance on medication rather than improved sleep hygiene. Choice D, sleeping for short intervals, does not necessarily signify improved sleep quality.
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 with signs and symptoms of double pneumonia states,"I will not agree to hospital admission unless my shaman is allowed to continue helping me." Which would be an appropriate nursing intervention?
- A. Tell the client that the shaman is not allowed in the emergency department.
- B. Have the shaman meet the attending physician at the hospital.
- C. Have the family talk the client into admission without the shaman.
- D. Explain to the client that the shaman is responsible for the client's condition.
Correct Answer: B
Rationale: The correct answer is B. Having the shaman meet the attending physician at the hospital is the most appropriate nursing intervention because it allows for collaboration between traditional beliefs and modern medical care. This approach respects the client's cultural and spiritual preferences while ensuring the client receives necessary medical treatment. It also helps establish a supportive and holistic care environment.
Choice A is incorrect because denying the shaman access may lead to resistance from the client and hinder effective communication and trust-building. Choice C is inappropriate as it disregards the client's autonomy and may create conflict within the family. Choice D is incorrect as blaming the shaman for the client's condition is disrespectful and unprofessional.
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.