Nokea
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.
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An alcohol-dependent patient was hospitalized at 0200 today. When would the nurse expect withdrawal symptoms to peak?
- A. Between 0800 and 1000 today (6 to 8 hours after drinking stopped)
- B. Between 0200 tomorrow and hospital day 2 (24 to 48 hours after drinking stopped)
- C. About 0200 on hospital day 3 (72 hours after drinking stopped)
- D. About 0200 on hospital day 4 (96 hours after drinking stopped)
Correct Answer: B
Rationale: The correct answer is B because alcohol withdrawal symptoms typically peak between 24 to 48 hours after the patient stops drinking. This timeframe aligns with the onset of symptoms such as tremors, anxiety, and hallucinations. Choices A, C, and D are incorrect because withdrawal symptoms do not peak within 6 to 8, 72, or 96 hours after drinking cessation. It is crucial for the nurse to monitor the patient closely during this critical period to manage and prevent potential withdrawal complications.
Your client in crisis is detaching from self. Which psychological ego defense mechanism is this client most likely using?
- A. Displacement
- B. Sublimation
- C. Dissociation
- D. Reaction formation
Correct Answer: C
Rationale: Dissociation (C) involves detaching from self in crisis.
Which basic activity of daily living assistive device can be useful for the client who is affected with poor fine motor coordination?
- A. An aphasia aid
- B. A button hook
- C. Honey thickened liquids
- D. A word board
Correct Answer: B
Rationale: A button hook (B) aids fine motor tasks like dressing.
Which intervention will have the greatest impact on reducing the stigma and rejection currently experienced by individuals with mental illness?
- A. Providing services to the mentally ill that minimize the need to rely upon the community
- B. Holding activities at mental health facilities that are open to the community to foster acceptance
- C. Educating local citizen groups on the needs and experiences of the mentally ill in their community
- D. Focusing on improving the socialization skills of mentally ill individuals living in the community
Correct Answer: C
Rationale: The correct answer is C: Educating local citizen groups on the needs and experiences of the mentally ill in their community. This intervention addresses the root cause of stigma - lack of understanding and awareness. By educating the community, misconceptions can be corrected, empathy can be cultivated, and stigma can be reduced. Choice A does not directly address stigma reduction but rather focuses on minimizing reliance on the community. Choice B, while promoting acceptance, may not necessarily tackle stigma at its core. Choice D, improving socialization skills, is beneficial but may not address the systemic issue of stigma. Ultimately, educating the community is key to fostering a more inclusive and supportive environment for individuals with mental illness.
An older woman diagnosed with Alzheimers disease lives with family and attends day care. After observing poor hygiene, the nurse talked with the caregiver. This caregiver became defensive and said, It takes all my energy to care for my mother. Shes awake all night. I never get any sleep. Which nursing intervention has priority?
- A. Teach the caregiver about the effects of sundowners syndrome.
- B. Secure additional resources for the mothers evening and night care.
- C. Support the caregiver to grieve the loss of the mothers cognitive abilities.
- D. Teach the family how to give physical care more effectively and efficiently.
Correct Answer: B
Rationale: The patients caregivers were coping with care until the patient began to stay awake at night. The family needs assistance with evening and night care to resume their pre-crisis state of functioning. Secondary prevention calls for the nurse to mobilize community resources to relieve overwhelming stress. The other interventions may then be accomplished.