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The mental health team is determining treatment options for a male patient who is experiencing psychotic symptoms. Which question(s) should the team answer to determine whether a community outpatient or inpatient setting is most appropriate? Select all that apply.
- A. Is the patient expressing suicidal thoughts?
- B. Does the patient have intact judgment and insight into his situation?
- C. Does the patient have experiences with either community or inpatient mental healthcare facilities?
- D. Does the patient require a therapeutic environment to support the management of psychotic symptoms?
Correct Answer: C
Rationale: To determine whether a community outpatient or inpatient setting is most appropriate for a patient experiencing psychotic symptoms, it is crucial to consider if the patient has had experiences with either community or inpatient mental healthcare facilities. This helps in assessing the familiarity and comfort level of the patient in those settings, aiding in decision-making regarding the level of care needed. The other choices, such as assessing suicidal thoughts (choice A), judgment and insight (choice B), and the need for a therapeutic environment (choice D), are important considerations in the overall treatment plan but do not directly address the setting appropriateness between community outpatient or inpatient care.
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A female client is brought to the emergency department after police officers found her disoriented, disorganized, and confused. The nurse also determines that the client is homeless and slightly suspicious. This client's treatment plan should include what priority problem?
- A. Self-care deficit.
- B. Disturbed sensory perception.
- C. Ineffective community coping.
- D. Acute confusion.
Correct Answer: D
Rationale: The correct answer is 'D: Acute confusion.' In the given scenario, the client is disoriented, disorganized, and confused, indicating acute confusion. This is a priority issue to address for immediate safety and appropriate care. Option A, self-care deficit, is not the priority as the client's safety and mental status take precedence. Option B, disturbed sensory perception, does not align with the client's presentation of confusion. Option C, ineffective community coping, is not the immediate concern as the client's cognitive state needs urgent attention.
A client who is known to abuse drugs is admitted to the psychiatric unit. Which medication should the nurse anticipate administering to a client who is exhibiting benzodiazepine withdrawal symptoms?
- A. Diphenhydramine (Benadryl)
- B. Perphenazine (Trilafon)
- C. Isocarboxazid (Marplan)
- D. Chlordiazepoxide (Librium)
Correct Answer: D
Rationale: Chlordiazepoxide (Librium) is the correct choice for managing benzodiazepine withdrawal symptoms. Benzodiazepines are commonly used drugs that can lead to physical dependence, and abrupt discontinuation can result in withdrawal symptoms. Chlordiazepoxide, a benzodiazepine itself, is often used in a controlled manner to taper off the drug gradually and manage withdrawal symptoms effectively. Choice A, Diphenhydramine, is an antihistamine and not typically used to manage benzodiazepine withdrawal. Choice B, Perphenazine, is an antipsychotic medication used to treat psychotic disorders, not specifically benzodiazepine withdrawal symptoms. Choice C, Isocarboxazid, is a monoamine oxidase inhibitor (MAOI) used in the treatment of depression and not indicated for benzodiazepine withdrawal.
The nurse on the day shift receives report about a client with depression who was found on the floor in the morning. What intervention is best for the nurse to implement?
- A. Assist the client to get out of bed and involved in an activity.
- B. Monitor the client's appetite and sleep patterns.
- C. Assess the client's feelings regarding the hospital stay.
- D. Explain that staff will check on the client every 30 minutes.
Correct Answer: A
Rationale: Assisting the client to engage in activities is the best intervention as it can help improve mood and prevent further decline in function. Option B, monitoring appetite and sleep patterns, is important but not the most immediate intervention needed in this situation. Option C, assessing feelings about the hospital stay, is also important but addressing the client's physical safety and well-being should take precedence. Option D, explaining the frequency of staff checks, is not as effective in addressing the client's immediate needs for engagement and support.
A female client with obsessive-compulsive personality disorder is admitted to the hospital for a cardiac catheterization. The afternoon before the procedure, the client begins to keep detailed notes of the nursing care she is receiving and reports her findings to the RN at bedtime. What action should the nurse implement?
- A. Explain to the client that her behavior invades the rights of the nursing staff.
- B. Ask the client to explain why she is keeping a detailed record of her nursing care.
- C. Teach the client strategies to control her obsessive-compulsive behavior.
- D. Encourage the client to express her feelings regarding the upcoming procedure.
Correct Answer: B
Rationale: Asking the client to explain why she is keeping a detailed record of her nursing care is the most appropriate action for the nurse to take in this situation. Understanding the client's motivations for keeping detailed records can provide insight into her obsessive-compulsive behaviors and help manage them effectively. Choice A is incorrect because it may come across as confrontational and not address the underlying reasons for the behavior. Choice C is incorrect as teaching strategies to control behavior should be done after understanding the client's motives. Choice D is incorrect as it does not directly address the behavior of keeping detailed records.
The client is being educated by the healthcare provider about starting a prescribed abstinence therapy with disulfiram (Antabuse). What information should the client understand?
- A. Maintain complete abstinence from heroin or cocaine use.
- B. Stay alcohol-free for at least 12 hours before the first dose.
- C. Participate in monthly Alcoholics Anonymous meetings.
- D. Disclose to others that he is a substance abuser.
Correct Answer: B
Rationale: The correct answer is B. Before starting disulfiram therapy (Antabuse), the client must comprehend the need to remain alcohol-free for a minimum of 12 hours. This is crucial to prevent the unpleasant and potentially dangerous reactions that can occur with concurrent alcohol consumption while on disulfiram. Choices A, C, and D are incorrect because they do not directly relate to the specific requirement for alcohol abstinence before initiating disulfiram therapy.