Exam (elaborations)

NR 326 CMS Exam(questions and answers completed)2022

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NR 326 CMS

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NR 326 CMS

What is Nurse John likely to note in a male client being admitted for alcohol withdrawal? A. Perceptual disorders B. Impending coma C. Recent alcohol intake D. Depression with mutism Option A: Frightening visual hallucinations are especially common in clients experiencing alcohol wit...

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nr 326 cms examquestions and answers completed2022
what is nurse john likely to note in a male client being admitted for alcohol withdrawal
june has agreed to take amitriptyline hcl elavil for 3

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NR 326 CMS Exam
What is Nurse John likely to note in a male client being admitted for alcohol withdrawal?
A. Perceptual disorders
B. Impending coma
C. Recent alcohol intake
D. Depression with mutism - Answer Option A: Frightening visual hallucinations are
especially common in clients experiencing alcohol withdrawal

June has agreed to take amitriptyline HCL (Elavil) for 3 days, but now complains that it
"doesn't help" and refuses to take it. What should the nurse say or do?
A. Withhold the drug
B. Record the client's response
C. Encourage client to tell the physician
D. Suggest that it takes awhile before seeing the results. - Answer Option D: The client
needs a specific response; that it takes 2 to 3 weeks (a delayed effect) until the
therapeutic blood level is reached.

In preparing a female client for electroconvulsive therapy (ECT), Nurse Michelle knows
that succinylcholine (Anectine) will be administered for which therapeutic effect?
A. Short acting anesthesia
B. Decreased oral and respiratory secretions
C. Skeletal muscle paralysis
D. Analgesia - Answer Option C: Succinylcholine (Anectine)is a depolarizing muscle
relaxant causing paralysis. It is used to reduce the intensity of muscle contractions
during the convulsive stage, thereby reducing the risk of bone fractures or dislocation

Nurse Gina is aware that the dietary implications for a client in manic phase of bipolar
disorder is:
A. Serve the client a bowl of soup
B. Increase calories, decrease fat, and decrease carbohydrates
C. Give the client pieces of cut up steak, potatoes, peas
D. Increase calories, increase carbohydrates, and increase protein - Answer Option D:
This client needs increased protein for tissue building and increased calories to replace
what is burned up (usually via carbohydrates); preferable, portable d/t acute mania sx
Potatoes- does not indicate if portable

What parental behavior toward a child during an admission procedure should cause
Nurse Ron to suspect child abuse?
A. Flat affect
B. Expressing guilt
C. Acting overly solicitous toward the child
D. Ignoring the child - Answer Option C: Acting overly solicitous (overly concerned,
mindful, anxiously concerned) toward the child
This behavior is an example of reaction formation, a coping mechanism.

,NR 326 CMS Exam
Nurse Lynnette notices that a female client with obsessive-compulsive disorder washes
her hands for long periods each day. How should the nurse respond to this compulsive
behavior?
A. By designating times during which the client can focus on the behavior
B. By urging the client to reduce the frequency of the behavior as rapidly as possible
C. By calling attention to, or attempting to prevent the behavior
D. By discouraging the client from verbalizing anxieties - Answer CORRECT - Option A:
The nurse should designate times during which the client can focus on the compulsive
behavior or obsessive thoughts.
Option B: The nurse should urge the client to reduce the frequency of the compulsive
behavior gradually, not rapidly.
Option C: She shouldn't call attention to, or try to prevent the behavior. Trying to prevent
the behavior may cause pain and terror to the client.
Option D: The nurse should encourage the client to verbalize anxieties to help distract
attention from the compulsive behavior.

After seeking help at an outpatient mental health clinic, Ruby, who was raped while
walking her dog, is diagnosed with posttraumatic stress disorder (PTSD). Three months
later, Ruby returns to the clinic, complaining of fear, loss of control, and helpless
feelings. Which nursing intervention is most appropriate for Ruby?
A. Recommending a high protein, low-fat diet
B. Giving sleep medication, as prescribed, to restore a normal sleep-wake cycle
C. Allowing the client time to heal
D. Exploring the meaning of the traumatic event with the client - Answer CORRECT -
Option D: The client with PTSD needs encouragement to examine and understand the
meaning of the traumatic event and consequent losses. Otherwise, symptoms may
worsen and the client may become depressed or engage in self-destructive behavior
such as substance abuse.
Option A: A special diet isn't indicated unless the client also has an eating disorder or a
nutritional problem.
Option B: The physician may prescribe antianxiety agents or antidepressants cautiously
to avoid dependence; sleep medication is rarely appropriate.
Option C: The client must explore the meaning of the event and won't heal without this,
no matter how much time passes. Behavioral techniques, such as relaxation therapy,
may help decrease the client's anxiety and induce sleep. Exposure therapy may also be
indicated.

Meryl, age 19, is highly dependent on her parents and fears leaving home to go away to
college. Shortly before the semester starts, she complains that her legs are paralyzed
and is rushed to the emergency department. When physical examination rules out a
physical cause for her paralysis, the physician admits her to the psychiatric unit where
she is diagnosed with conversion disorder. Meryl asks the nurse, "Why has this
happened to me?" What is the nurse's best response?
A. "You've developed this paralysis so you can stay with your parents. You must deal
with the conflict if you want to walk again."

, NR 326 CMS Exam
B. "It must be awful not to be able to move your legs. You may feel better if you realize
the problem is psychological, not physical."
C. "Your problem is real but there is no physical basis for it. We'll work on what is going
on in your life and why it's happened."
D. "It isn't uncommon for someone with your personality to develop a conversion
disorder during times of stress." - Answer CORRECT - Option C: The nurse must be
honest with the client by telling her that the paralysis has no physiologic cause while
also conveying empathy and acknowledging that her symptoms are real. The client will
benefit from psychiatric treatment, which will help her understand the underlying cause
of her symptoms. After the psychological conflict is resolved, her symptoms will
disappear.
Option A: Telling her that she has developed paralysis to avoid leaving her parents or
that her personality caused her disorder wouldn't help her understand and resolve the
underlying conflict.
Option B: Saying that it must be awful not to be able to move her legs wouldn't answer
the client's question; knowing that the cause is psychological wouldn't necessarily make
her feel better.

Nurse Trina knows that the following drugs have been known to be effective in treating
obsessive-compulsive disorder (OCD):
A. Benztropine (Cogentin) and diphenhydramine (Benadryl)
B. Chlordiazepoxide (Librium) and Diazepam (Valium)
C. Fluvoxamine (Luvox) and Clomipramine (Anafril)
D. Divalproex (Depakote) and Lithium (Lithobid) - Answer CORRECT - Option C: The
antidepressants fluvoxamine and clomipramine have been effective in the treatment of
OCD.
Option B: Librium and Valium may be helpful in treating anxiety related to OCD but
aren't drugs of choice to treat the illness.
Options A and D: The other medications mentioned aren't effective in the treatment of
OCD.

Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone
(BuSpar). The nurse is aware that the teaching instructions for newly prescribed
buspirone should include which of the following?
A. A warning about the drug's delayed therapeutic effect, which is from 14-30 days
B. A warning about the incidence of neuroleptic malignant syndrome (NMS)
C. A reminder of the need to schedule blood work in 1 week to check blood levels of the
drug
D. A warning that immediate sedation can occur with a resultant drop in pulse - Answer
CORRECT - Option A: The client should be informed that the drug's therapeutic effect
might not be reached for 14 to 30 days. The client must be instructed to continue taking
the drug as directed.
Option B: NMS hasn't been reported with this drug, but tachycardia is frequently
reported.
Option C: Blood level checks aren't necessary

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