Nokea
The primary organ for drug elimination is the:
- A. skin
- B. lung(s)
- C. kidney(s)
- D. liver
Correct Answer: C
Rationale: The correct answer is the kidney(s) because most drugs are excreted in the urine, either as the parent compound or as drug metabolites. The skin is not the primary organ for drug elimination; only a few drugs are excreted in sweat. The lung(s) primarily excrete volatile gases with expiration, not drugs. While the liver metabolizes drugs, it is the kidney(s) that primarily eliminate drugs through urine, especially those with a molecular weight above 300.
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The child with seizure disorder is being treated with Dilantin (phenytoin). Which of the following statements by the patient's mother indicates to the nurse that the patient is experiencing a side effect of Dilantin therapy?
- A. "She is very irritable lately."?
- B. "She sleeps quite a bit of the time."?
- C. "Her gums look too big for her teeth."?
- D. "She has gained about 10 pounds in the last 6 months."?
Correct Answer: C
Rationale: The correct answer is '"Her gums look too big for her teeth."?' Hyperplasia of the gums is a known side effect associated with Dilantin therapy. Option A, '"She is very irritable lately,"?' is not a typical side effect of Dilantin. Option B, '"She sleeps quite a bit of the time,"?' is a common side effect of Dilantin but not specific to gum hyperplasia. Option D, '"She has gained about 10 pounds in the last 6 months,"?' is not typically associated with Dilantin therapy and is unrelated to the question.
A client reports that someone is in the room and trying to kill him. The nurse's best response is:
- A. "No one is in your room. Let's get you more medicine."?
- B. "I do not see anyone, but you seem to be very frightened."?
- C. "No one can hurt you here."?
- D. "Just tell the person to go away."?
Correct Answer: B
Rationale: When a client reports hallucinations or delusions, it is crucial to respond in a non-confrontational and empathetic manner. Choice B acknowledges the client's fear without confirming the delusion, showing understanding, and providing reassurance. This response validates the client's feelings without reinforcing the false belief. The other responses in choices A, C, and D dismiss the client's feelings or perceptions, which can escalate the situation and harm the therapeutic relationship.
While admitting a client to an acute-care psychiatric unit, the nurse asks about substance abuse based on:
- A. psychiatric disorders' higher prevalence in addicted populations
- B. individuals with psychiatric disorders' increased susceptibility to substance abuse
- C. the importance of detecting and diagnosing substance disorders in acute-care psychiatric settings
- D. the significant impact of undetected substance problems on the treatment of psychiatric disorders
Correct Answer: B
Rationale: The correct answer is 'individuals with psychiatric disorders' increased susceptibility to substance abuse.' It is crucial to inquire about substance abuse during admission to an acute-care psychiatric unit because individuals with psychiatric disorders are more prone to experiencing substance abuse issues. Addressing substance abuse is vital for effective treatment and to prevent relapse in psychiatric disorders. Option A is incorrect as it focuses on the prevalence of psychiatric illness in addicted populations rather than the relationship between psychiatric disorders and substance abuse. Option C is incorrect as it exaggerates the ease of detecting and diagnosing substance disorders in acute-care psychiatric settings. Option D is incorrect as undetected substance problems can indeed significantly impact the treatment of psychiatric disorders, but the main reason for inquiring about substance abuse is the increased susceptibility of individuals with psychiatric disorders to such issues.
The client is diagnosed with multiple myeloma. The doctor has ordered cyclophosphamide (Cytoxan). Which instruction should be given to the client?
- A. "Walk about a mile a day to prevent calcium loss."?
- B. "Increase the fiber in your diet."?
- C. "Report nausea to the doctor immediately."?
- D. "Drink at least eight large glasses of water a day."?
Correct Answer: D
Rationale: Cyclophosphamide (Cytoxan) can cause hemorrhagic cystitis, a condition characterized by inflammation of the bladder wall leading to bleeding. To prevent this complication, the client should drink at least eight glasses of water a day. Walking to prevent calcium loss (choice A) and increasing fiber intake (choice B) are not directly related to the side effects of Cytoxan, making them unnecessary instructions in this case. While nausea is a common side effect of chemotherapy, the immediate reporting of nausea to the doctor (choice C) is important but not specifically related to the use of Cytoxan in this scenario.
When the nurse who was not promoted first read the memo and learned that the other nurse had received the promotion, she left the room in tears. This behavior is an example of:
- A. conversion.
- B. regression
- C. introjection.
- D. rationalization
Correct Answer: B
Rationale: Crying is a regressive behavior. The ego returned to an earlier, comforting, and less-mature way of behaving in the face of disappointment. Regression involves reverting to an earlier stage of development to cope with stress or conflict. In this scenario, the nurse regressed to a childlike state by crying when faced with the disappointment of not getting the promotion, demonstrating regression as a defense mechanism. Conversion involves transforming anxiety into a physical symptom. Introjection involves unconsciously identifying intensely with another person. Rationalization involves unconsciously creating acceptable explanations to justify unacceptable ideas, actions, or feelings. Therefore, the correct answer is regression as it aligns with the nurse's behavior of regressing to a childlike state by crying due to the disappointment of not receiving the promotion.