B. Dilated pupils - A nurse in an emergency department is assessing a client for suspected cocaine intoxication. Which of the following findings should
... [Show More] the nurse expect?
A. Nystagmus
B. Dilated pupils
C. Hypersomnia
D. Depression
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A. "The main side effects are temporary, and may include mild confusion, a headache, and short-term memory loss." - A nurse is caring for a client who has major depressive disorder and is scheduled for electroconvulsive therapy (ECT). The client's spouse asks the nurse about the possible side effects of the ECT. Which of the following responses should the nurse make?
A. "The main side effects are temporary, and may include mild confusion, a headache, and short-term memory loss."
B. "Most clients have no adverse effects to this treatment, but muscle cramping may result from the induced seizure."
C. "Some clients have been known to have a myocardial infarction, but we will monitor your spouse closely to be certain this does not happen."
D. "The most common side effects are directly related to the use of anesthesia."
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C. "I don't see any bugs, but you seem very frightened." - A nurse is caring for a client who has a history of alcohol use disorder and has been hospitalized for detoxification. The nurse enters the room and finds the client shouting in a terrified voice, "Get these bugs off of me!" Which of the following responses by the nurse is appropriate?
A. "I'm sure that the bugs you see will not harm you."
B. "Tell me more about the bugs that you see in your room."
C. "I don't see any bugs, but you seem very frightened."
D. "I do not see anything. This is part of the withdrawal process."
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B. Slowed breathing - A nurse is teaching a community education course about the physical complications related to substance use disorder. Which of the following findings should the nurse include in the discussion as a health risk of heroin use?
A. Acute pancreatitis
B. Slowed breathing
C. Nasal septum perforation
D. Permanent short-term memory loss
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B. Personal history of alcohol use disorder. - A nurse is collecting a health history on a client who has a diagnosis of Wernicke-Korsakoff syndrome. Which of the following is an expected finding?
A. Family history of Alzheimer's disease.
B. Personal history of alcohol use disorder.
C. Undergoing current treatment for HIV.
D. Current rehabilitation for opiate addiction
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A. Methadone - A nurse is caring for a client who is withdrawing from opioids. Which of the following medications should the nurse prepare to administer?
A. Methadone
B. Disulfiram
C. Risperidone
D. Lithium carbonate
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A. Tremors - A nurse is assessing a client who is experiencing acute cocaine toxicity. Which of the following findings should the nurse expect?
A. Tremors
B. Hypothermia
C. Hypotension
D. Respiratory depression
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D. Talk the client through tasks one step at a time. - A nurse on a long-term care unit is creating a plan of care for a client who has Alzheimer's disease. Which of the following interventions should the nurse include in the plan?
A. Rotate assignment of daily caregivers.
B. Provide an activity schedule that changes from day to day.
C. Limit time for the client to perform activities.
D. Talk the client through tasks one step at a time.
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D. Forgetfulness gradually progressing to disorientation - A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestations should the nurse tell the family to expect?
A. Decreased auditory and visual acuity
B. Decreased display of emotions
C. Personality traits that are opposite of original traits
D. Forgetfulness gradually progressing to disorientation
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A. Grooming
B. Long-term memory
D. Affect - A nurse is performing a mental status examination (MSE) on a client who has a new diagnosis of dementia. Which of the following components should the nurse include? (Select all that apply.)
A. Grooming
B. Long-term memory
C. Support systems
D. Affect
E. Presence of pain
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A. Dysrhythmias - A nurse is caring for a client who has severe manifestations of schizophrenia and is medicated PRN for agitation with haloperidol. The nurse should assess the client for which of the following adverse effects?
A. Dysrhythmias
B. Cataracts
C. Pancreatitis
D. Bleeding
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B. Tongue thrusting and lip smacking
D. Facial grimacing and eye blinking
E. Involuntary pelvic rocking and hip thrusting movements - A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? (Select all that apply.)
A. Urinary retention and constipation
B. Tongue thrusting and lip smacking
C. Fine hand tremors and pill rolling
D. Facial grimacing and eye blinking
E. Involuntary pelvic rocking and hip thrusting movements [Show Less]