A nurse is monitoring a client who ingested an overdose of phenobarbital sodium. For which of the following adverse effects of toxicity should the nurse
... [Show More] assess the client?
Respiratory depression
A nurse in a mental health facility is planning to promote the development of a theraputic relationship with a newly admitted client. Which of the following actions should the nurse plan to take?
Identify professional boundaries during the initial interaction
Incorporating the attributes or feelings of another person into oneself
Introjection
A nurse is assisting with the care of a client who is experiencing acute alcohol withdrawal. Which of the following medications should the nurse prepare to administer?
Lorazepam; this will maintain vitals, prevent seizures, and delirium tremens
A nurse on an inpatient mental health unit is planning care for a client who was admitted following a suicide attempt. Which of the following actions should the nurse include in the plan?
Observe the client swallow medications
A nurse is contributing to the plan of care for a newly admitted client who has bipolar disorder and is experiencing acute mania. Which of the following client goals should the nurse identify as the priority?
Adequate hydration-this prevents physical exhaustion, maintains health, and meets nutritional and rest needs during this phase of mania. Think of Maslows hierarchy of needs.
A nurse is caring for a client with alcohol use disorder. Following alcohol withdrawl, which of the following medications should the nurse expect to administer to the client during maintenence?
Disulfiram (Antabuse)
Medication that is given to patients who are withdrawing from opioids
Methadone
Medication that is administered during alcohol withdrawl
Chlordiazepoxide- helps prevent seizures and delirium tremens
Medication that is administered during an opioid/narcotic overdose
Naloxone
A home health nurse is talking with the partner of a client who has dementia. Which of the following statements by the partner indicates that the client is displaying signs of apraxia?
"Yesterday my partner put a jacket on upside down"
A nurse is observing a patient who has histrionic personality disorder. Which of the following behaviors should the nurse expect?
The client whispers into the providers ear—acting provocatively and seductively is an expected behavior of an individual with histrionic personality disorder.
Patients who manifest expressionless demeanor and exhibit social withdrawl have this personality disorder
Schizoid personality disorder
Patients who manifest constant reassurance due to a lack of self confidence and an excessive need to be cared for have this personality disorder
Dependent personality disorder
A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for valproic acid. The nurse should explain that the provider will routinely prescribe which of the following tests while the client is taking valproic acid?
LFT's— due to the risk of hepatotoxicity
A nurse is collecting data from a client who is taking lithium to treat bipolar disorder and has a lithium level of 2.2 mEq/L. Which of the following findings should the nurse expect?
Blurry vision—Lithium toxicity occurs between 2-2.5; sx. Include blurry vision, ataxia, clinic twitching, severe hypotension, and polyuria.
Early signs of lithium toxicity
Levels between 1.0-1.5 = Fine tremors, nausea, vomiting, diarrhea, muscle weakness, lethargy
Adverse effect of lithium
Hypothyroidism
Late signs of lithium toxicity
Levels above 2.5 = seizures and Liguria; levels above 3.5 = delirium, cardiovascular collapse, coma, and death
A nurse is reviewing the laboratory report of a patient who is taking risperidone. The nurse should identify that which of the following results indicates a potential adverse reaction to the medication?
Elevated blood glucose
A nurse is caring for a newly admitted client who is recieving treatment for alcohol use disorder. The client tells the nurse, "I have not had anything to drink for 6 hours". Which of the following findings should the nurse expect during alcohol withdrawl?
Insomnia, restlessness, elevated temperature, muscle tremors, tachycardia
A nurse is collecting data from a client who has bipolar disorder and is in a manic state. Which of the following findings is the highest priority?
The client reports sleeping 2-3 hours per night— the greatest risk is injury from exhaustion
A nurse is collecting data from a client who has cocaine intoxication. Which of the following findings should the nurse expect?
Increased mental alertness, elevated BP, exxagerated emotional response (euphoria and possible aggression), elevated body temp [Show Less]