1) A nurse is contributing the plan of care for a client admitted with a paranoid personality disorder. What are important recommendations to make during
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• When contributing to the plan of care, safety is priority. Some clients with PD are at risk for
violence or self-injury.
• Clients with personality disorder often have the comorbidity of substance abuse and/or a history of violent and nonviolent crimes.
• The nurse should set limits, be consistent, and firm, yet supportive when providing care.
2) A nurse is caring for a client hospitalized for opioid dependency. What manifestations should the nurse anticipate when abstinence syndrome begins?
• Abstinence syndrome:
o Onset begins with sweating, runny nose, goose bumps, tremors, and irritability.
o Symptoms then progress to severe weakness, diarrhea, fever, insomnia, pupil dilation, nausea and vomiting, pain in muscles and bone, and muscle spasms
3) How do delirium and dementia differ in onset and outcome?
• Delirium has a rapid onset and can occur in as little as a few hours to a few days. The outcomes re reversible if it is diagnosed and treated as soon as possible.
• Dementia, or Major neurocognitive disorder, involves deterioration of function that occurs gradually over months or years. The outcome with dementia is irreversible and progressive.
4) The nurse is reviewing the admission information on a client being admitted with schizophrenia. The provider has indicated that the client has schizophrenia with negative symptoms. What would the nurse expect to notice in this client? How do negative symptoms differ from the positive symptoms of schizophrenia?
• Negative symptoms involve the absence of things that are normally present and are usually
more difficult to treat. Positive symptoms involve manifestations of things that are not normslly present and are usually identified more easily.
• Negative symptoms include flat or blunted affect, anergia, alogia, anhedonia, and
avolition.
• Positive symptoms include hallucinations, delusions, altered speech, and bizarre behavior.
5) A nurse is caring for a client with a binge eating disorder. 1) What is binge-eating disorder? 2) What disorders is this client at increased risk for because of the weight gain associated with binge eating?
• Binge eating is where a client consumes a large quantity of food over a short duration
without compensatory behaviors such as purging or use of laxatives.
• Binge eating causes weight gain which in turn puts the client at risk for developing type 2 Diabetes Mellitus, High blood pressure, and cancer.
6) A nurse is reinforcing client education about the risk of hepatotoxicity with the drug valproic acid. What information should be included?
• Signs and symptoms of hepatotoxicity include anorexia, N&V, fatigue, jaundice, and
abdominal pain
• The nurse should obtain a baseline liver function test and monitor function regularly about every 2 months.
• The nurse should educate the client on these signs and symptoms and advise them to notify the physician if any occur.
7) A parent inquires as to how long before their child gets better after taking the methylphenidate. How would the nurse best reply?
• Full therapeutic effect can take up to 6 weeks after the initial dose.
8) A nurse is evaluating a client’s understanding of Transcranial Magnetic Stimulation (TMS). What is TMS and what can the client expect to experience during the procedure?
• Transcranial Magnetic Stimulation is a noninvasive therapy that’s uses magnetic pulsations to
stimulate the cerebral cortex of the brain.
• This procedure lasts 30 to 40 minutes and involves an electromagnet to be placed on the client’s scalp, the client is awake and may feel a tapping or knocking sensation in the head, scalp skin contraction, and tightening of the jaw muscles during the procedure.
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