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The physician has ordered atropine 5 mg intramuscularly (IM) for a patient to be administered 30 minutes prior to ECT. The rationale for use of this medication is that it reduces secretions and:
- A. Improves the scope of convulsive activity
- B. Reduces the need for recovery room staff
- C. Prevents incontinence of bladder and bowel
- D. Increases the patient's alertness post-procedure.
Correct Answer: A
Rationale: The rationale for using atropine 5 mg IM prior to ECT is to protect against vagal bradycardia, not to improve the scope of convulsive activity, reduce the need for recovery room staff, or prevent incontinence of bladder and bowel. Atropine is a muscarinic antagonist that blocks the effects of acetylcholine on muscarinic receptors, leading to an increase in heart rate and protection against bradycardia that can occur during ECT.
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Which nursing diagnosis is appropriate for a patient who insists on being called "Your Highness" and demonstrates loosely associated thoughts?
- A. Risk for violence
- B. Defensive coping
- C. Impaired memory
- D. Disturbed thought processes
Correct Answer: D
Rationale: nsisting on being called "Your Highness" and demonstrating loose associations suggests a disturbance in thought processing typical of schizophrenia.
A nurse plans a staff education program for employees of a senior living community. Which topic has priority?
- A. Late-onset schizophrenia
- B. Dementia
- C. Depression and suicide
- D. Delirium
Correct Answer: C
Rationale: Depression and suicide are serious concerns for elderly individuals and should be prioritized in education for caregivers to ensure early identification and intervention.
An outcome for a patient experiencing anticipatory grieving for a spouse diagnosed with
terminal cancer would be that the patient will:
- A. Continue to be emotionally involved with the dying spouse
- B. Develop protective mental mechanisms to allay the pain of spousal loss
- C. Not voice threats of physical violence that is either self or others directed
- D. Agree to stay at home and care for the spouse with appropriate assistance
Correct Answer: D
Rationale: Anticipatory grieving involves preparing emotionally for the upcoming loss. The patient may begin to focus on caregiving and emotional preparation. Agreeing to care for the spouse with assistance reflects an adaptive coping mechanism during this period.
A young woman had just learned of the accidental death of her husband. She begins to cry and states, “It’s not fair! How could he do this to me?” This remark is assessed as:
- A. An explosive episode
- B. An expression of anger
- C. Fear of making decisions alone
- D. A sign of despair.
Correct Answer: B
Rationale: The woman's statement, "It's not fair! How could he do this to me?" expresses a sense of anger and injustice over her husband's accidental death. She is questioning why this has happened to her, which suggests feelings of anger and frustration. This expression is not necessarily a plea for help or a manifestation of fear of making decisions alone, but it is a clear display of anger and a sense of unfairness in the situation.
A nurse administers ordered preoperative glycopyrrolate (Robinul) 30 minutes prior to a client’s electroconvulsive therapy (ECT) procedure. What is the rationale for administering this medication?
- A. Robinul decreases anxiety during the ECT procedure.
- B. Robinul induces an unconscious state to prevent pain during the ECT procedure
- C. Robinul prevents severe muscle contractions during the ECT procedure.
- D. Robinul decreases secretions to prevent aspiration during the ECT procedure.
Correct Answer: D
Rationale: Glycopyrrolate is an anticholinergic that reduces salivation and other secretions, which helps to prevent aspiration during ECT, where muscle relaxants are used.