Nokea
The nurse reviews various treatment options with the group members. Which of the following are considered most therapeutic in treating obsessive-compulsive disorder (OCD)? Select all that apply.
- A. Selective serotonin reuptake inhibitors (SSRIs) such as fluvoxamine (Luvox)
- B. Electroconvulsive therapy (ECT)
- C. Cognitive-behavioral therapy
- D. Surgical prefrontal lobotomy
- E. Tranquilizers such as diazepam (Valium)
- F. A self-help class on the Internet
Correct Answer: A,C
Rationale: SSRIs and cognitive-behavioral therapy, particularly exposure and response prevention, are evidence-based treatments for OCD, targeting symptoms effectively.
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The client is admitted to the ED with multiple lacerations and broken bones after being assaulted. The client’s spouse barges into the client’s ED room with a gun and states “I’m going to kill you and anyone else who gets in my way.” Which action should be taken by the nurse initially?
- A. Yell for help to distract the person’s attention away from the client.
- B. Firmly state “You don’t want to hurt anyone else. Let’s talk about it.”
- C. Use gestures to alert another nurse to clear others who may be nearby.
- D. Use a nonaggressive posture and tone to state “Put the gun on the floor.”
Correct Answer: D
Rationale: Using a nonaggressive posture and tone (D) to request the gun be placed down de-escalates the situation safely. Yelling (A) may startle and escalate assuming intent (B) blocks communication and gesturing (C) risks escalation if noticed.
The 19-year-old is given a court order to enter treatment for cocaine abuse. The client threatens to leave the treatment facility AMA. Which statement by the nurse demonstrates an accurate understanding of the client’s options?
- A. “The client is of legal age and can leave on his own will; we can’t stop him from leaving.”
- B. “Due to the court order the client is not allowed to leave and will be placed in seclusion.”
- C. “The client is allowed to leave as long as the court is informed; I’ll prepare the documents.”
- D. “The client cannot leave and will be returned to treatment or another option by court order.”
Correct Answer: D
Rationale: Court-ordered clients cannot leave voluntarily (D). Age (A) is irrelevant seclusion (B) is illegal informing court (C) doesn’t allow leaving.
The client who recently emigrated from Iran is on the mental health unit and has been placed in seclusion. The nurse assesses that the client is now calm and ready to be assimilated back into the mental health milieu. Which action by the nurse demonstrates cultural insensitivity?
- A. Gives the client a thumbs-up gesture
- B. Avoids looking at the clock or a watch
- C. Has the NA bring the client a cup of tea
- D. Offers to bring the client the book of Quran
Correct Answer: A
Rationale: A thumbs-up (A) is offensive in Iranian culture akin to a vulgar gesture. Avoiding clocks (B) offering tea (C) and providing the Quran (D) are culturally appropriate.
If the client's pain is the result of a panic attack, which findings will the nurse most likely note during the physical assessment? Select all that apply.
- A. Tachycardia
- B. Hypotension
- C. Increased salivation
- D. Constricted pupils
- E. Sweating
- F. Unsteady gait
Correct Answer: A,E
Rationale: Panic attacks typically cause tachycardia and sweating due to sympathetic nervous system activation, reflecting acute anxiety.
The nurse is caring for the client who is 2 days postadmission to a medical unit and has a long history of heavy alcohol abuse. The nurse should monitor for which acute complications related to alcohol abuse? Select all that apply.
- A. Seizures
- B. Pancreatitis
- C. GI bleeding
- D. Exophthalmos
- E. Delirium tremens
Correct Answer: A ,B ,C, E
Rationale: Seizures (A) pancreatitis (B) GI bleeding (C) and delirium tremens (E) are acute risks. Exophthalmos (D) is unrelated.