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NSG 2400 Exam 1 EAQ Questions.
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NSG 2400 Exam 1 EAQ Questions.
A client with a diagnosis of schizophrenia is discharged from the hospital. At home the
client forgets to take the medication, is unable to function, and must be rehospitalized.
What medication may be prescribed that can be administered on an outpatient basis
every 2 to 3 weeks?
1
Lithium
2
Diazepam
3
Fluvoxamine
4
Fluphenazine - ANS-4
Fluphenazine
Fluphenazine can be given intramuscularly every 2 to 3 weeks to clients who are
unreliable about taking oral medications; it allows them to live in the community while
keeping the disorder under control. Lithium is a mood-stabilizing medication that is
given to clients with bipolar disorder. This drug is not given for schizophrenia. Diazepam
is an antianxiety/anticonvulsant/skeletal muscle relaxant that is not given for
schizophrenia. Fluvoxamine is a selective serotonin reuptake inhibitor; it is administered
for depression, not schizophrenia.
.
A client with bulimia nervosa eats two sandwiches, two salads, and four desserts for
lunch. What client behavior should the nurse anticipate after the meal is consumed?
1
Excessive exercise
2
Hoarding of more food for a later binge
3
Active socializing with small groups of clients
4
Withdrawing from the group to go to the bathroom - ANS-4
Withdrawing from the group to go to the bathroom
,Bulimia is characterized by the binge-purge cycle; most clients withdraw from others
and vomit after an eating binge. Although some individuals with bulimia may exercise to
excess, this is a more common finding with the diagnosis of anorexia nervosa. Although
individuals with bulimia may hoard food, this behavior commonly occurs later, when
limits are put on their intake. Most individuals with bulimia do not seek support or
socialization after a binge, although they may socialize at other times.
A 20-year-old carpenter falls from a roof and sustains fractures of the right femur and
left tibia. The client reveals a history of substance abuse. What is the primary
consideration for the nurse who is caring for this client?
1
Confronting the client about substance abuse
2
Avoiding calling attention to the client's drug abuse
3
Determining the amount and time of last use of the substance
4
Realizing that this client will need more pain medication than a nonabuser - ANS-3
Determining the amount and time of last use of the substance
Determining the amount and last use of the substance is the priority. Nurses should
base their treatment of withdrawal symptoms on the time and amount of last use.
Confronting the client is not the nurse's responsibility at this time. The client must be
helped to recognize that a problem with drugs exists, but this is not the priority. Because
of cross-tolerance the client may need larger doses of analgesia for pain relief than a
nonabuser would, but this is not the priority.
A 45-year-old client who recently completed alcohol detoxification reports plans to begin
using disulfiram (Antabuse) as part of the alcoholism treatment regimen. What important
client teaching does the nurse share regarding this drug?
1
Voluntary compliance with the disulfiram regimen is very high.
2
A single dose of oral disulfiram will be effective for up to 72 hours.
3
Disulfiram may be taken intramuscularly and will be effective for as long as 7 days.
4
Foods, medications, and any topical preparation containing alcohol should be avoided. -
ANS-4
,Foods, medications, and any topical preparation containing alcohol should be avoided.
Disulfiram causes unpleasant physical effects when mixed with alcohol. Any substance
that contains alcohol may trigger an adverse reaction. Voluntary compliance with the
use of disulfiram is often very low because of the negative physical effects experienced
by the individual if alcohol is ingested. For disulfiram to be effective, it must be taken
orally every day. Disulfiram is not administered intramuscularly.
A cachectic adolescent with the diagnoses of anorexia nervosa, dehydration, and
electrolyte imbalances is admitted to a mental health facility. The adolescent has been
obsessed with weight, has exercised for hours every day, has taken enemas and
laxatives several times a week, and has engaged in self-induced vomiting. What
outcome is a priority for the nurse planning care for this client?
1
Identifying personal strengths
2
Controlling impulsive behaviors
3
Correcting electrolyte imbalances
4
Developing a contract for treatment goals - ANS-3
Correcting electrolyte imbalances
Electrolyte imbalances can precipitate life-threatening dysrhythmias. Although clients
with the diagnosis of anorexia nervosa have low self-esteem, and identifying and
supporting strengths promote the development of a positive self-regard, this is not the
priority at this time. Clients with anorexia are perfectionists who usually do not display
impulsivity. Developing a contract for treatment outcomes is difficult to accomplish
initially, because anorexic clients often deny the illness and evade therapeutic
treatment.
A client has been hospitalized for 3 weeks while receiving a tricyclic medication for
severe depression. One day the client says to the nurse, "I'm really feeling better; my
energy level is up." After the encounter an aide tells the nurse that the client has given
away a favorite jacket. What should the nurse conclude that the client's statement
indicates?
1
Improved mood
2
Improved socialization
, 3
Increased risk for suicide
4
Heightened need for independence - ANS-3
Increased risk for suicide
When the energy level improves in the depressed client, the risk for suicide increases;
also, the client has given away a personal belonging, which may indicate a plan to
commit suicide. Elevated mood may be true, but the gift of a cherished personal
belonging decreases the possibility that the client's statement simply reflects an
improvement in mood. The client's socialization may be improved, but the gift of a
valuable personal belonging decreases the possibility that the act simply reflects an
improved level of socialization. Giving something away is unrelated to independence.
A client has just been admitted with the diagnosis of borderline personality disorder.
There is a history of suicidal behavior and self-mutilation. What does the nurse
remember is the main reason that clients use self-mutilation?
1
Control others
2
Express anger or frustration
3
Convey feelings of autonomy
4
Manipulate family and friends - ANS-2
Express anger or frustration
Typically, recurrent self-mutilation is an expression of intense anger, helplessness, or
guilt or is a form of self-punishment. Self-mutilation is used not to control others but for
self-validation; also, it is a means of blocking psychological pain by inducing physical
pain. Self-destructive behaviors are not an expression of autonomy but rather an
expression of negative feelings of anger, rage, and abandonment. Self-destructive
behaviors represent not an attempt to manipulate others but rather a way to blunt
emotional pain.
A client has the diagnosis of histrionic personality disorder. Which behavior should the
nurse expect when assessing this client?
1
Boastful and egotistical
2
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