Barbara with bipolar disorder is being treated with lithium for the first time. Nurse Clint should observe the client for which common adverse effect of lithium?
-
Solution
Polyuria
Option A: Polyuria commonly occurs early in the treatment with lithium and could result in fluid volume deficit.
Erlinda, age 85, with major depression undergoes a sixth electroconvulsive therapy (ECT) treatment. When assessing the client immediately after ECT, the nurse expects to find:
-
Solution
Transitory short and long-term memory loss and confusion
Option D: ECT commonly causes transitory short and long-term memory loss and confusion, especially in geriatric clients. It rarely results in permanent short and long-term memory loss.
Jose who is receiving monoamine oxidase inhibitor antidepressant should avoid tyramine, a compound found in which of the following foods?
-
Solution
Aged cheese and Chianti wine
Option C: Aged cheese and Chianti wine contain high concentrations of tyramine.
Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for:
-
Solution
General anesthesia
Option A: The nurse should prepare a client for ECT in a manner similar to that for general anesthesia.
Rosana is in the second stage of Alzheimer’s disease who appears to be in pain. Which question by Nurse Jenny would best elicit information about the pain?
-
Solution
“Do you hurt? (pause) “Do you hurt?”
Option B: When speaking to a client with Alzheimer’s disease, the nurse should use close-ended questions. Those that the client can answer with “yes” or “no” whenever possible and avoid questions that require the client to make choices. Repeating the question aids comprehension.
Which nursing action is most appropriate when trying to diffuse a client’s impending violent behavior?
-
Solution
Helping the client identify and express feelings of anxiety and anger
Option D: In many instances, the nurse can diffuse impending violence by helping the client identify and express feelings of anger and anxiety. Such statement as “What happened to get you this angry?” may help the client verbalizes feelings rather than act on them.
Tony with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobia include:
-
Solution
Severe anxiety and fear
Option A: Phobias cause severe anxiety (such as panic attack) that is out of proportion to the threat of the feared object or situation. Physical signs and symptoms of phobias include profuse sweating, poor motor control, tachycardia and elevated B.P.
Which of the following drugs has been known to be effective in treating obsessive-compulsive disorder (OCD)?
-
Solution
Fluvoxamine (Luvox) and clomipramine (Anafranil)
Option C: The antidepressants fluvoxamine and clomipramine have been effective in the treatment of OCD.
When performing a physical examination on a female anxious client, nurse Nelli would expect to find which of the following effects produced by the parasympathetic system?
-
Solution
Hyperactive bowel sounds
Option B: The parasympathetic nervous system would produce incomplete G.I. motility resulting in hyperactive bowel sounds, possibly leading to diarrhea.
Nurse Jessie is assessing a client suffering from stress and anxiety. A common physiological response to stress and anxiety is:
-
Solution
Diarrhea
Option D: Diarrhea is a common physiological response to stress and anxiety.