Nokea
When the client begins crying and says, 'Nurse, I feel like I'm going to die,' which response is most therapeutic?
- A. You are having a panic attack.
- B. You don't want the physician to see you this way.
- C. Everyone feels frightened in an emergency.
- D. I'll stay with you until you feel better.
Correct Answer: D
Rationale: Staying with the client provides reassurance and support, directly addressing their fear and promoting a sense of security.
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The student participating in college sports is suspected of abusing anabolic steroids and is referred to the college’s health service. Which nursing assessment findings are consistent with anabolic steroid abuse? Select all that apply.
- A. Acne vulgaris
- B. Aggressive behavior
- C. Heavy menstruation
- D. Urinary tract infection
- E. Thickening of the hair
- F. Edema of the hands and feet
Correct Answer: A ,B ,D, E
Rationale: Anabolic steroids cause acne (A) aggression (B) UTIs (D) and hair thinning (E not thickening). Heavy menstruation (C) is incorrect; menses cease. Edema (F) may occur but isn’t selected.
The client states “I don’t see any problem with smoking a little weed. It isn’t addictive.” Which response by the nurse is most accurate?
- A. “Marijuana is a natural chemical that has many therapeutic uses but it is still illegal to use.”
- B. “Marijuana is not addictive. The danger is that it often leads to abuse of more illicit drugs.”
- C. “Marijuana has effects similar to alcohol hallucinogens and sedatives that are addictive.”
- D. “There are no withdrawal symptoms so it is controversial whether marijuana is addictive.”
Correct Answer: C
Rationale: Marijuana’s addictive effects mimic CNS depressants and hallucinogens (C). It’s addictive with withdrawal (D) not just a gateway (B) and legality (A) is irrelevant.
If the client snorts cocaine on a regular basis, which physical assessment findings will the nurse most likely find? Select all that apply.
- A. Dry, stuffy nose
- B. Perforated nasal septum
- C. Hoarseness and cough
- D. Sinus pain under the eyes
- E. Elevated blood pressure
- F. Inability to sleep
Correct Answer: A,B,D,E,F
Rationale: Regular cocaine snorting causes nasal irritation, septal damage, sinus pain, hypertension, and insomnia due to its stimulant effects.
If a client with chronic mental illness develops the following symptoms after the physician discontinues haloperidol, which one is most likely a consequence of the drug therapy?
- A. Facial tics
- B. Depression
- C. Patchy hair loss
- D. Daytime lethargy
Correct Answer: A
Rationale: Facial tics are a potential tardive dyskinesia symptom, a known side effect of long-term haloperidol use.
The nurse assesses the client every 15 minutes. What objective evidence will the nurse detect that indicates that the restraints are too tight? Select all that apply.
- A. The client reports being unable to move the right hand.
- B. The client's fingers and toes are pale.
- C. The client reports having pain.
- D. Capillary refill is greater than 6 seconds.
- E. There is excoriation around the wrist.
- F. The client reports numbness and tingling.
Correct Answer: B,D,F
Rationale: Pallor, prolonged capillary refill, and numbness indicate impaired circulation, suggesting restraints are too tight and compromising blood flow.