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The nurse recognizes which of these symptoms as characteristic of a panic attack?
- A. Palpitations, decreased perceptual field, diaphoresis, fear of going crazy.
- B. Decreased blood pressure, chest pain, choking feeling.
- C. Increased blood pressure, bradycardia, shortness of breath.
- D. Increased respiratory rate, increased perceptual field, increased concentration ability.
Correct Answer: A
Rationale: panic disorders are characterized by recurrent, unpredictable attacks of intense apprehension or terror that can render a client unable to control a situation or to perform simple tasks; client can experience palpitations, chest pain, shortness of breath, a decrease in perceptual field, and a fear of 'losing it' or going crazy
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A client who has a panic disorder is receiving paroxetine HCl (Paxil). The client has been taking the drug for one week and is still having severe panic attacks. The client tells the nurse that she thinks the drug is not working. What is the best response for the nurse to make?
- A. You should ask your physician for a different drug.
- B. The physician will probably add another drug to your regimen.
- C. You should stop taking the medication if it is not effective.
- D. It takes two to four weeks for Paxil to be effective.
Correct Answer: D
Rationale: Paroxetine, an SSRI, requires 2-4 weeks to reach therapeutic effect for panic disorder, explaining the continued symptoms.
A 24-year-old woman who is 30 weeks pregnant is seen in the outpatient clinic for a routine visit.
The nurse would be MOST concerned if the client made which of the following statements?
- A. During the day I seem to get hot flashes and chills.
- B. I am having some trouble with constipation and hemorrhoids.
- C. At the end of the day I have leg cramps.
- D. When I put my hand on my abdomen, I can feel it tense and relax.
Correct Answer: A
Rationale: Strategy: 'MOST concerned' indicates a complication. (1) correct-should be reported to the physician (2) common due to pressure of growing fetus (3) common due to compression of nerves supplying lower extremities or reduced calcium levels, should take oral calcium supplements if ordered, stretch until spasm is relieved (4) Braxton-Hicks contractions common, should rest and change position
A client has orders for cefoxitin (Mefoxin) 2 g IV piggyback in 100 cc 5% dextrose in water. The primary IV is 5% dextrose in lactated Ringer's and is infusing by gravity.
It is MOST important for the nurse to take which of the following actions?
- A. Administer the medication slowly, at 25-25 cc/h.
- B. Change the primary IV solution.
- C. Hang the piggyback infusion bag higher than the primary infusion bag.
- D. Obtain an infusion pump prior to administration.
Correct Answer: C
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) antibiotic should be administered within one hour (2) unnecessary for safe infusion (3) correct-when using a gravity drip, piggyback fluid level needs to be higher than primary infusion (4) unnecessary for safe infusion
While assessing a client in an outpatient facility with a panic disorder, the nurse completes a thorough health history and physical exam. Which finding is most significant for this client?
- A. Compulsive behavior
- B. Sense of impending doom
- C. Fear of flying
- D. Predictable episodes
Correct Answer: B
Rationale: Sense of impending doom. The feeling of overwhelming and uncontrollable doom is characteristic of a panic attack.
A woman calls the physician's office stating that her 16-year-old daughter took 20 or 30 sleeping pills. The mother tells the nurse that her daughter is awake and says, 'Leave me alone. I just want to die.' How should the nurse respond?
- A. Ask her why she wants to die.'
- B. Try to convince her that she wants to live.'
- C. Give her a glass of milk to bind the medication.'
- D. Call 911 and get her to the closest emergency room immediately.'
Correct Answer: D
Rationale: A suicide attempt with sleeping pills requires immediate emergency care to prevent overdose complications. Other responses delay critical intervention.