Nokea
While reviewing the client's psychiatric history, the nurse would expect to note which major characteristic of bipolar disorder?
- A. Ritualistic behavior
- B. Symbolic aggressiveness
- C. Cyclic mood swings
- D. Periodic amnesia
Correct Answer: C
Rationale: Cyclic mood swings, alternating between mania and depression, are the hallmark of bipolar disorder, defining its clinical presentation.
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Multiple clients are being cared for on the behavioral health unit. In which circumstances should the nurse plan the therapeutic use of seclusion and/or restraints? Select all that apply.
- A. The client asks to be placed in seclusion.
- B. The client expresses the likelihood of self-injury.
- C. The staff feels the client is likely to harm others.
- D. A legally detained client is threatening to “escape.”
- E. The staff identifies seclusion as a consequence of the client’s behavior.
- F. The client’s threatening behavior is negatively affecting the therapeutic milieu.
Correct Answer: A, B ,C, D
Rationale: Seclusion/restraints are therapeutic for client request (A) self-injury risk (B) harm to others (C) or escape threats (D). Punishment (E) or milieu disruption (F) alone are not indications.
If the nurse notes the following symptoms after the client begins taking sertraline (Zoloft), which one is most likely drug-related?
- A. Polyuria
- B. Diplopia
- C. Drooling
- D. Insomnia
Correct Answer: D
Rationale: Insomnia is a common side effect of sertraline, an SSRI, due to its activating effects on the central nervous system.
What is the best approach for reorienting a confused client who wanders into other clients' rooms?
- A. Place a large sign with the client's name on the door.
- B. Keep the room doors on the unit locked at all times.
- C. Restrain the client in a wheelchair when unattended.
- D. Speak to the client about invading other people's privacy.
Correct Answer: C
Rationale: Restraining in a wheelchair prevents wandering while respecting dignity, though it must be used cautiously and per protocol.
If the client has all of the following strengths, which one is most important for coping with this diagnosis?
- A. Acceptance by religious leaders
- B. A close circle of support
- C. Acquisition of many social acquaintances
- D. Sexual tolerance within the community
Correct Answer: B
Rationale: A close support network provides emotional and practical assistance, critical for coping with the challenges of an HIV diagnosis.
Staff members have expressed fear of the client who has a history of violent behavior. Which response made by the lead nurse would be most beneficial in addressing the staff’s expressed concerns?
- A. “Let’s not prejudge him. His medication should help him control his behavior.”
- B. “I will be very attentive to his behavior monitoring it for any signs of escalation.”
- C. “It may be hard but we need to appear calm and nonthreatening but alert to his behavior.”
- D. “As staff we are all trained to manage violent clients and we can handle any crisis behavior.”
Correct Answer: C
Rationale: Appearing calm and nonthreatening (C) addresses staff concerns and guides management. Prejudging (A) personal monitoring (B) or overconfidence (D) dismiss staff fears.