Nokea
The nurse notifies the treatment team that the client's electroconvulsive therapy treatment scheduled for 9:45 a.m. is to be cancelled when the:
- A. Client's wife calls and reports she will be unable to get to the hospital before the treatment.
- B. Medication nurse gives him his regularly scheduled antihypertensive medication at 7 a.m.
- C. Night shift staff reports that the client slept fitfully and reports having 'bad dreams.'
- D. Client eats his usual breakfast of buttered toast, cooked cereal, tea, and juice.
Correct Answer: D
Rationale: The correct answer is D because food intake before electroconvulsive therapy (ECT) can increase the risk of aspiration during the procedure, which can be life-threatening. Buttered toast, cooked cereal, tea, and juice are considered solid food items that should be avoided before ECT to prevent complications. Choices A, B, and C are not immediate contraindications for canceling the ECT session. A: The client's wife being late does not impact the safety of the procedure. B: Taking antihypertensive medication does not pose a direct risk before ECT. C: Fitful sleep and bad dreams do not indicate a need for cancellation unless related to a medical emergency.
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Which of the following guidelines for the use of nonconventional modalities is correct?
- A. Health care providers should make every attempt to ascertain alternative therapy use during each visit
- B. All 'natural' products are generally safe
- C. Health care providers should support all alternative therapies
- D. When using alternative medicines, more is always better than less
Correct Answer: A
Rationale: Assessing use at each visit ensures safety and coordination with conventional care.
Which model looks at how internal family relationships affect family functioning?
- A. Systems theory
- B. Narrative therapy
- C. Structural family therapy
- D. Social work case management
Correct Answer: C
Rationale: SFT specifically examines internal relational structures like boundaries and alignments.
Which statement made by a mental health nurse demonstrates the need for further education regarding active listening as a therapeutic communication technique?
- A. When I use therapeutic silence, I'm giving the client time to think and reflect.'
- B. Sharing perceptions doesn't mean I tell the client how my experiences are similar to his.'
- C. I generally find it helpful to ask the client why he blames others for the mistakes he's made.'
- D. It's not therapeutic to give the client suggestions as to what he needs to do to fix his problems.'
Correct Answer: C
Rationale: The correct answer is C because asking the client why he blames others is not a recommended approach in active listening. This statement shows a lack of understanding of active listening principles. Active listening focuses on listening without judgment or assumptions, understanding the client's perspective, and reflecting back their feelings. Asking why a client blames others can come across as confrontational and may hinder the therapeutic relationship. Choices A, B, and D demonstrate an understanding of active listening principles by emphasizing the importance of silence, avoiding sharing personal experiences, and refraining from giving direct advice, respectively.
What should be considered when assessing the effectiveness of the dosage of Valium a patient has been receiving for six months?
- A. Potential for tolerance/dependence exists - doses may need to be increased
- B. Gastrointestinal disturbances
- C. Sexual dysfunction
- D. Selective serotonin reuptake inhibitors (SSRIs)
Correct Answer: A
Rationale: The correct answer is A: Potential for tolerance/dependence exists - doses may need to be increased. When assessing the effectiveness of Valium dosage, it's crucial to consider tolerance and dependence because long-term use can lead to reduced efficacy, necessitating dose adjustments. This is important for ensuring the patient receives the optimal therapeutic benefit. Gastrointestinal disturbances (B) and sexual dysfunction (C) are potential side effects of Valium but are not directly related to assessing dosage effectiveness. Selective serotonin reuptake inhibitors (D) are a different class of medications and not relevant to evaluating Valium dosage.
Ginger, age 19 and an only child, left 3 months ago to attend a college of her choice 500 miles away from her parents. It is Ginger’s first time away from home. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. This type of crisis is called:
- A. Crisis resulting from traumatic stress
- B. Dispositional crisis
- C. Psychiatric emergency
- D. Maturational/developmental crisis
Correct Answer: D
Rationale: The correct answer is D: Maturational/developmental crisis. This type of crisis occurs during life transitions or developmental stages, such as leaving home for the first time to attend college. Ginger's anxiety attacks are likely due to the stress and adjustment challenges associated with this significant life change. She is experiencing difficulties in decision-making and seeking constant reassurance from her mother, which are common behaviors during maturational crises.
Explanation:
1. A: Crisis resulting from traumatic stress does not apply as Ginger's anxiety is not triggered by a specific traumatic event.
2. B: Dispositional crisis is not the correct choice as this crisis is not related to her inherent personality traits but rather to the developmental stage she is going through.
3. C: Psychiatric emergency does not fit as Ginger's situation does not present an immediate threat to her safety or require urgent psychiatric intervention.
In summary, the correct choice is D as Ginger's symptoms align with a maturational/developmental crisis associated