What is first-line therapy for insomnia?
- A. Complementary therapies such as melatonin
- B. Cognitive-behavioral therapies such as relaxation therapy
- C. Benzodiazepine-receptor-like agents (e.g., zolpidem [Ambien])
- D. Over-the-counter medication such as diphenhydramine (Benadryl)
Correct Answer: B
Rationale: The correct answer is B. Cognitive-behavioral therapy (CBT) is the first-line treatment for insomnia due to its effectiveness and lack of side effects. Melatonin (A) and over-the-counter medications (D) are secondary options, while benzodiazepines (C) are reserved for short-term use.
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What are these sensory phenomena called when a client hears voices or sees images that do not objectively exist?
- A. Mania
- B. Delusions
- C. Seasonal affective disorder
- D. Hallucinations
Correct Answer: D
Rationale: Hallucinations involve perceiving things that are not present, such as hearing voices or seeing images.
To communicate with a patient who does not speak the dominant language, the nurse should
- A. Speak slowly and enunciate clearly in a slightly louder voice.
- B. Use gestures and pantomime words while verbalizing specific words.
- C. Use family members rather than strangers as interpreters to increase the patient’s feeling of comfort.
- D. Use a dictionary or phrase books that translate from both the nurse’s language and the patient’s language.
Correct Answer: A
Rationale: Speaking slowly, using gestures, and utilizing translation tools facilitate effective communication. Using family members as interpreters can introduce bias and inaccuracies.
What is an example of a pertinent negative finding during a physical examination?
- A. Chest pain that does not radiate to the arm
- B. Elevated blood pressure in a patient with hypertension
- C. Pupils that are equal and react to light and accommodation
- D. Clear and full lung sounds in a patient with chronic bronchitis
Correct Answer: A
Rationale: The correct answer is 'Chest pain that does not radiate to the arm.' Pertinent negatives highlight clinically significant absences of expected findings, helping rule out certain conditions like cardiac ischemia.
A healthcare provider is preparing to admit a client to the PACU who received a competitive neuromuscular blocking agent. Which of the following items should the provider place at the client's bedside?
- A. Bag valve mask device
- B. Defibrillator machine
- C. Chest tube equipment
- D. Central venous catheter tray
Correct Answer: A
Rationale: The correct answer is A: Bag valve mask device. In the PACU, a client who received a competitive neuromuscular blocking agent may have impaired respiratory function. Placing a bag valve mask device at the bedside is crucial for providing immediate respiratory support if needed. This device allows manual ventilation in case of respiratory distress.
Summary:
- Choice B: Defibrillator machine is not necessary for a client receiving a competitive neuromuscular blocking agent.
- Choice C: Chest tube equipment is not typically needed for this situation.
- Choice D: Central venous catheter tray is not directly related to the respiratory support required for a client with impaired respiratory function.
Before giving a beta-adrenergic blocker glaucoma agent, you would notify the physician if the client discloses a history of what condition?
- A. Hypertension
- B. Tachycardia
- C. Rheumatoid arthritis
- D. Bradycardia
Correct Answer: D
Rationale: Beta-adrenergic blockers can exacerbate bradycardia, so the physician should be notified before administration.