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ANSWERS LATEST UPDATE, RATED A+.
A nurse is contributing to the plan of care for a client who has bipolar disorder and whose admission was voluntary. For which of the following interventions should the nurse confirm that the client has given informed consent? Recelving light therapy Participating in a group exercise program Attending a cognitive behavioral therapy class Taking an experimental medication - CORRECT ANSWERS Taking an experimental medication A nurse is caring for a client who has agreed to a verbal safety contract following a self-mutilation attempt. Which of the following behaviors indicates that the contract has been effective? The client displaces their feelings of self harm until they talk to the provider. The client suppresses their feelings when they are angry. The client notifies the nurse when they want to harm themselves. The client goes to their room alone when they feel overwhelmed. - CORRECT ANSWERS The client notifies the nurse when they want to harm themselves.
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A nurse is caring for a client who has a new prescription for lithium. Which of the following should the nurse monitor during treatment? Oxygen saturation Triglyceride Blood glucose Sodium - CORRECT ANSWERS Sodium A nurse is on the elevator and overhears two nurses discussing a client on the unit. Which of the following actions should the nurse take? Tell the nurses to stop the discussion. Complete a written warning for each of the nurses. Discuss the occurrence with the cilent. Report the issue to the ethics committee - CORRECT ANSWERS Tell the nurses to stop the discussion.
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A nurse is reviewing the medical record of a client who is to receive electroconvulsive therapy. The nurse should notify the provider for which of the following findings? Asthma Renal colic Crohns disease Cardiac arrhythmia - CORRECT ANSWERS Cardiac arrhythmia A nurse is caring for a client who has antisocial personality disorder. Which of the following actions should the nurse take to intervene for manipulative behaviors during group therapy? Ignore manipulative behaviors during the session. Discuss consequences of inappropriate behaviors. Bargain with the client regarding established behavioral expectations.
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Place the client in seclusion immediately after inappropriate behavior occurs. - CORRECT ANSWERS Discuss consequences of inappropriate behaviors A client who delivered a healthy newborn 4 weeks ago calls her provider's office and tells the nurse. "This baby constantly cries. My partner works all the time, and I can't take any more." Which of the following responses is the nurse's priority? "Tell me about your baby. Where is she now?" Have you discussed this with your partner?" "Do you have a friend who could help you?" "Having a newborn must be stressful. Do you have other children? - CORRECT ANSWERS "Having a newborn must be stressful. Do you have other children? A nurse is caring for a client who states, "I'm overwhelmed, and no one understands. I can't take it anymore." Which of the following responses should the nurse make first? "Do you have anyone you can talk to about your feelings?" "Are you saying that no one understands your concerns?" "Are you thinking of harming yourself?"
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Withnoid the next dose of aripiprazol Accompany the client to a private area. - CORRECT ANSWERS Accompany the client to a private area. A nurse is observing a newly hired nurse communicate with a client. The newly hired nurse asks. "You take your medications at a different time than prescribed?" Which of the following communication techniques is the newly hired nurse using? Offering self Exploring Presenting reality Reflecting - CORRECT ANSWERS Presenting reality A nurse is caring for a client who was placed in four-point restraints by the nursing staff following an episode of violent behavior. Which of the following actions should the nurse take? Request the provider renew the prescription in 24 hr. Keep staff interactions with the client to a minimum.
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Provide range-of-motion exercises to all extremities every 2 hr. Document the client's behavior in the medical record every 1 hr. - CORRECT ANSWERS Request the provider renew the prescription in 24 hr. A nurse is caring for a client who has terminal cancer and is receiving palliative care. Which of the following statements indicates that the client is demonstrating effective coping? I hope to have surgery to cure my cancer." "I need to return to work as soon as my treatment is complete. " I should start making my funerat arrangements." I still believe my cancer will go into remission." - CORRECT ANSWERS I should start making my funerat arrangements." A nurse is collecting data from a client who has schizophrenia. Which of the following client statements indicates that the client is experiencing a command hallucination? Can you see these spiders crawling all over me?'
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WBC count 6,000/mm O HDA1C 4% Sodium 138 mEg/L - CORRECT ANSWERS Potassium 2.8 mEg/L A nurse in an urgent care facility is collecting data from a group of clients. The nurse should identify that which of the following clients is at risk for experiencing a maturational crisis? A client who was sexually assaulted A client who is in the process of getting a divorce A client who recently retired from a longtime job A client who lost her home in a fire - CORRECT ANSWERS A client who recently retired from a longtime job A nurse is caring for a male client who is to begin therapy with valproic acid. Which of the following diagnostic results should the nurse plan to review before administering the first dose?
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Prostate specific antigen test Liver function tests Chest x-ray Urine culture - CORRECT ANSWERS Liver function tests A nurse is caring for a newly admitted client who has schizophrenia and hearing loss. Which of the following actions should the nurse take first when communicating with the client? Face the client when speaking so the client can read lips. Evaluate the client's understanding of the message. Contact a sign-language Interpreter to communicate with the client. Determine how the client prefers to communicate. - CORRECT ANSWERS Face the client when speaking so the client can read lips A nurse is collecting data from an adult client in an outpatient mental health clinic. The nurse should identify which of the following events as a potential cause of a maturational crisis?
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"How old were you when you started your menses?" "Do you have medical insurance?" Who do you talk to when you are upset?" When did you last have a mammogram?" - CORRECT ANSWERS When did you last have a mammogram?" A nurse is collecting data from a client who has a new diagnosis of bipolar disorder. Which of the following behaviors supports this diagnosis? Excessive dietary intake Paranoid thinking Ritualistic actions constant talking - CORRECT ANSWERS Paranoid thinking A nurse in a mental health facility is discussing client rights with an adult client who was involuntarily committed. Which of the following statements should the nurse make?
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"If you want to leave the hospital, you need to sign a release form." Once 90 days have passed, you can request a review of your admission." Your provider will need to notify your employer of your admission. You have the option to refuse your medication while in the facility." - CORRECT ANSWERS You have the option to refuse your medication while in the facility." A nurse is contributing to the plan of care for a client who experiences panic attacks. Which of the following strategies should be included for implementation during an attack? Explore with the chent what precipitates an attack. Minimize environmental stimuli. Assist the client with evaluating their coping mechanisms. Encourage the client to set goals. - CORRECT ANSWERS Explore with the client what precipitates an attack. A nurse is contributing to the plan of care for a client who is experiencing a panic level of anxiety. Which of the following interventions should the nurse include? (Select all that apply.)
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Diarrhea Excessive salivation - CORRECT ANSWERS Urinary retention A nurse is monitoring a client who is receiving haloperidol. Which of the following findings is the priority to report to the provider? Hypoactive bowel sounds in all four quadrants client report of dry mouth Client report of photosensitivity Constant opening and closing of mouth - CORRECT ANSWERS Constant opening and closing of mouth A nurse in a mental health facility is caring for an adolescent who is newly admitted for an overdose of prescription pain medication. The client has prescriptions for an anxiolytic and an SSRI antidepressant. Which of the following precautions should the nurse take? Restrict interactions with other clients. Document the client's behavior every 2 hr.
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implement 24-hr one-to-one nursing observation. Administer prescribed medication via the IM route. - CORRECT ANSWERS Document the client's behavior every 2 hr. A nurse in a mental health facility is contributing to the plan of care for a new client. Which of the following actions should the nurse plan to include in the working phase of the nurse-client relationship? Establish a regular meeting time with the client. Collect data about the clients current health status. Determine whether the client's goals are met. Provide the client with information on problem-solving. - CORRECT ANSWERS Establish a regular meeting time with the client. A nurse is contributing to the plan of care for a client who is to start therapy with fluoxetine. Which of the following is an expected outcome for this client? Decreased hallucinations Improved mood
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"Let's take a walk. We can look for your partner." "I am sure you miss your partner" - CORRECT ANSWERS "I am sure you miss your partner" A nurse is caring for a client who has an opioid use disorder. The nurse should anticipate that the provider will prescribe which of the following medications for treatment? Phenobarbital Chlordiazepoxide buprenorphine Diazepam - CORRECT ANSWERS buprenorphine A nurse is beginning a therapeutic relationship with a client who has paranoid personality disorder. Which of the following strategies should the nurse plan to use? Be vague when answering the client's questions about instructions. Use an overly friendly approach.
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Demonstrate a neutral demeanor. Ask the client why he is suspicious of others. - CORRECT ANSWERS Be vague when answering the client's questions about instructions. A nurse is collecting data from a client regarding the client's sexual behavior. The client laughs and makes an inappropriate sexual comment. Which of the following is an appropriate response by the nurse? "I am concerned by your response. Can you explain your comment? I don't approve of that comment. We will discuss this later." That is very inappropriate. Why would you say that?" You shouldn't laugh about this. This is a serious topic." - CORRECT ANSWERS That is very inappropriate. Why would you say that?" A nurse is reinforcing teaching with a client about naltrexone. Which of the following statements by the client indicates an understanding of teaching? If I drink alcohol with this medication. I will experience ringing in my ears. I will not experience alcohol withdrawal If I take this medication.
