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Question 1
A patient with a history of cocaine use reports a concurrent history of
using other
... [Show More] drugs in order to counteract the effects of cocaine. Which drug
is this patient likely to have abused?
Selected
Answer:
Alcohol
Answers: PCP
Alcohol
Methylpheni
date
Caffeine
Response
Feedback:
Alcohol is a depressant which can neutralize the effects of
cocaine, which is a stimulant. Caffeine, methylphenidate (used
to treat ADHD) and the illegal drug PCP are also stimulating and
would only exacerbate the effects of cocaine.
Question 2
A patient is admitted with a heart rate of 53 bpm, respirations 6/min, temp
96.8 and pinpoint pupils. Based on these clinical manifestations, what
substance did this patient most likely overdose on?
Selected
Answer:
Marijuana
Answers: Opioids
Alcohol
Marijuana
Amphetam
ine
Response
Feedback:
Opioids include prescribed medications such as oxycodone and
morphine, and the illegal substance heroin. The above
symptoms are typical of opioid overdose, but are not typically
seen with marijuana, alcohol or amphetamines.
Question 3
An elderly client with cognitive impairment is combative and pulled out a
nasogastric tube, intravenous line, and indwelling urinary catheter. What
can the nurse anticipate that the health care provider will most likely
prescribe?
Selected
Answer:
A small dose of a selective serotonin
reuptake inhibitor
Answers: A small dose of a selective serotonin
reuptake inhibitor
A large dose of a benzodiazepine
A maintenance dose of buspirone
A small dose of an atypical antipsychotic
Response
Feedback
:
Aggressive behavior can be safely managed by antipsychotic
medication. Initial dosing should be small and raised cautiously
until behavior is controlled. Selective serotonin reuptake
inhibitors are not indicated for aggressive behavior. If a
benzodiazepine is used, the initial dose should be low.
Buspirone is not effective if given on an as-needed basis. It is
administered in small divided doses daily to control agitation.
Question 4
A nursing care plan contains the intervention “monitor for complications of
refeeding syndrome.” Which body system should a nurse most closely
monitor for clinical manifestations of dysfunction?
Selected
Answer:
Central
nervous
Answers: Renal
Central
nervous
Endocrine
Cardiovascu
lar
Response
Feedback:
Refeeding resulting in too-rapid weight gain can overwhelm the
heart, resulting in cardiovascular collapse; thus focused
assessment becomes a necessity to ensure patient
physiological integrity. The other body systems are not initially
involved in the refeeding syndrome.
Question 5
Which of the following is the best example of all-or-nothing thinking, a
common cognitive distortion of patients with an eating disorder?
Selected
Answer:
“If I gain any weight, I’ll keep going until I’m huge.”
Answers: “If I gain any weight, I’ll keep going until I’m huge.”
“When people tell me I’m looking better, they really
mean I’m fatter.”
“No one likes me because I’m fat.”
“When I’m thin, I’m perfect.”
Response
Feedback:
In all-or-nothing thinking, the person cannot see any middle
ground between extremes; a person with an eating disorder will
see themselves as either thin or immense. The other comments
are common in eating disorders but are not examples of all-ornothing thinking.
Question 6
A nurse reports to the interdisciplinary team that a patient with an
antisocial personality disorder lies to other patients, verbally abuses a
patient with Alzheimer’s disease, and flatters the primary nurse. This
patient is detached and superficial during counseling sessions. Which
behavior most clearly warrants limit setting?
Selected
Answer:
Flattering the nurse
Answers: Lying to other patients
Flattering the nurse
Verbal abuse of another patient
Detached superficiality during
counseling
Response
Feedback:
Limits must be set in areas in which the patient’s behavior
affects the rights of others. Limiting verbal abuse of another
patient is a priority intervention. The other concerns should be
addressed during therapeutic encounters.
Question 7
Which of the following are primary characteristics of a person with
borderline personality disorder?
Selected
Answer:
Demonstrated a self-defeating cycle of
behavior
Answers: Demonstrates flexibility and
compromise
Demonstrates socially appropriate
behaviors
Demonstrates eagerness to learn new
coping skills
Demonstrated a self-defeating cycle of
behavior
Response
Feedback
:
A self-defeating cycle of behavior is a hallmark of borderline
personality disorder, creating difficulties is work, social and
family relationships. Individuals with a borderline personality are
inflexible and do not compromise easily. Socially inappropriate
behavior is common in borderline personality, as is an
unwillingness to change and learn new coping skills
Question 8
A nurse is working with a patient with a histrionic personality disorder.
Which of the following nursing interventions must be implemented
throughout the inpatient stay?
Selected
Answer:
Setting appropriate limits on maladaptive behaviors
Answers: Setting appropriate limits on maladaptive behaviors
Offering relationship advice
Providing multiple options when the patient makes frequent
requests
Having the patient approach different staff members for
interpretation of unit rules
Response
Feedback
:
Setting firm limits and maintaining consistency are essential
elements in working with people with personality disorders.
Flexibility and providing too many choices does not help the
individual with boundaries and limits. Offering relationship
advice is not professional behavior and can have a negative
effect on the nurse-client relationship. Encouraging the patient
to attend daily activities may be a part of the care plan, but is
not as high of a priority as setting limits
Question 9
A patient has blindness related to conversion disorder. In order to assist
the patient with eating, which of the following interventions should the
nurse implement?
Selected
Answer:
Expect the patient to feed himself after explaining
arrangement of the food on the tray.
Answers: Establish a “buddy” system with other patients who can feed
this patient at each meal.
Expect the patient to feed himself after explaining
arrangement of the food on the tray.
Address the needs of other patients in the dining room, then
feed this patient.
Direct the patient to locate items on the tray independently
and feed himself unassisted.
Response
Feedback:
The patient is expected to maintain some level of
independence by feeding self, while the nurse is supportive in
a matter-of-fact way. The distracters support dependency or
offer little support.
Question 10
A patient is admitted for psychiatric observation after being arrested for
breaking windows in the home of a former girlfriend who had refused to
see him. His history reveals childhood abuse by a punitive father, torturing
family pets, and an arrest for disorderly conduct. Which nursing diagnosis
has priority in the plan of care?
Selected
Answer:
Post-trauma syndrome
Answers: Risk for injury
Post-trauma syndrome
Disturbed thought
processes
Risk for other-directed
violence
Response
Feedback:
The defining characteristics for Risk for other-directed violence
include a history of being abused as a child, having committed
other violent acts, and demonstrating poor impulse control. The
defining characteristics for the other diagnoses are not present
in the scenario [Show Less]