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Question 1: (see full question)

A client who recently developed paralysis of the arms is diagnosed with conversion disorder after tests fail to uncover a physical cause for the paralysis. Which intervention should the nurse include in the plan of care? Exercising the client's arms regularly

You selected: Correct

Explanation: To maintain the integrity of the affected areas and prevent muscle...(more) Explanation: To maintain the integrity of the affected areas and prevent muscle wasting and contractures, the nurse should help the client perform regular passive range-of-motion exercises with his arms. The nurse shouldn't insist that the client use his arms, such as by eating without assistance, because the client can't consciously control symptoms and move his arms. Also, such insistence may anger the client and endanger the therapeutic relationship. The nurse should include family members in the client's care because they may be contributing to the client's stress or conflict and are essential in helping the client regain function of his arms. The client isn't experiencing pain and, therefore, doesn't need education regarding pain management. (less)

Question 2: (see full question)

After seeking help at an outpatient mental health clinic, a client who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, the client returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for this client? Exploring the meaning of the traumatic event with the client

You selected: Correct

Explanation: The client with PTSD needs encouragement to examine and understand...(more) Explanation: 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. 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. The physician may prescribe antianxiety agents or antidepressants cautiously to avoid dependence; sleep medication is rarely appropriate. A special diet isn't indicated unless the client also has an eating disorder or a nutritional problem. (less)

Question 3: (see full question)

A client is undergoing treatment for an anxiety disorder. Such a disorder is considered chronic and generalized when excessive anxiety and worry about two or more life circumstances exist for at least: 6 months.

You selected: Correct

Explanation: For generalized anxiety disorder, the diagnostic criteria listed i...(more) Explanation: For generalized anxiety disorder, the diagnostic criteria listed in the Diagnostic and Statistic Manual of Mental Disorders, 4th edition, Text Revision include unrealistic or excessive anxiety and worry about two or more life circumstances for 6 months or more. (less)

Question 4: (see full question)

The nurse in a psychiatric inpatient unit is caring for a client with obsessive- compulsive disorder. As part of the client's treatment, the psychiatrist orders lorazepam (Ativan), 1 mg by mouth three times per day. During lorazepam therapy, the nurse should remind the client to: avoid caffeine. Explanation: Ingesting 500 mg or more of caffeine can significantly alter the a...(more) Explanation: Ingesting 500 mg or more of caffeine can significantly alter the anxiolytic effects of lorazepam. Other dietary restrictions are unnecessary. Staying out of the sun or using sunscreens is required when taking phenothiazines. An adequate salt intake is necessary for clients receiving lithium. (less)

Correct response:

Question 5: (see full question) You selected: Correct

A client comes to the emergency department while experiencing a panic attack. The nurse should respond to a client having a panic attack by: staying with the client until the attack subsides.

Explanation: The nurse should remain with the client until the attack subsides....(more) Explanation: The nurse should remain with the client until the attack subsides. If the client is left alone, he may become more anxious. Giving false reassurance is inappropriate in this situation. The client should be allowed to move around and pace to help expend energy. The client may be so overwhelmed that he can't follow lengthy explanations or instructions, so the nurse should use short phrases and slowly give one direction at a time. (less)

Question 6: (see full question)

A client arrives on the psychiatric unit exhibiting extreme excitement, disorientation, incoherent speech, agitation, frantic and aimless physical activity, and grandiose delusion. Which nursing diagnosis takes highest priority for the client at this time? Risk for injury

You selected: Correct

Explanation: This client is at increased risk for injury because of severe hype...(more) Explanation: This client is at increased risk for injury because of severe hyperactivity, disorientation, and agitation. Although the other options also are appropriate, the client's safety takes highest priority. The nurse should take immediate action to protect the client from injury. (less)

Question 7: (see full question)

During the admission data collection, a client with a panic disorder begins to hyperventilate and says, "I'm going to die if I don't get out of here right now!" What is the nurse's best response?

You selected: Correct

"You're having a panic attack. I'll stay here with you."

Explanation: During a panic attack, the nurse's best approach is to orient the ...(more) Explanation: During a panic attack, the nurse's best approach is to orient the client to what is happening and provide reassurance that the client won't be left alone. The anxiety level is likely to increase and the panic attack is likely to continue if the client is told to calm down (as in option 1), asked the reasons for the attack (as in option 2), or left alone (as in option 3). (less)

Question 8: (see full question)

A client with a history of drug and alcohol abuse is concerned that the hospital will divulge her history to her employer without her knowledge. What response by the nurse would be appropriate? "Your personal health information can't be disclosed to your employer without your permission."

You selected: Correct

Explanation: No one can legally divulge this information without the client's p...(more) Explanation: No one can legally divulge this information without the client's permission. Doing so violates the client's right to confidentiality. The employer doesn't have the right to private health care information without the client's permission. The physician can't divulge health care information without the client's permission. (less)

Question 9: (see full question)

A nurse on the psychiatric unit realizes that she typically fails to administer medications according to schedule. What's the best way for the nurse to improve her medication administration practice? Evaluate her current practice and devise an improvement plan.

You selected: Correct

Explanation: The nurse should evaluate her current medication administration pr...(more) Explanation: The nurse should evaluate her current medication administration practice and then devise an improvement plan. The nurse shouldn't change administration times to accommodate client care schedules. Reviewing medication administration principles won't improve the efficiency of her current practice. Asking a colleague to track the amount of time it takes her to administer medications is inappropriate and may cause an administration error. (less)

Question 10: (see full question)

A client with obsessive-compulsive disorder tells the nurse that he must check the lock on his apartment door 25 times before leaving for an appointment. The nurse knows that this behavior represents the client's attempt to: reduce anxiety.

You selected: Correct

Explanation: A compulsion is a repetitive act or impulse. Carrying out a compul...(more) Explanation: A compulsion is a repetitive act or impulse. Carrying out a compulsion helps a person reduce anxiety unconsciously. An obsessive-compulsive client doesn't want to call attention to himself and can't control his thoughts. This client's priority is to reduce anxiety not maintain the safety of the home. (less)

Question 11: (see full question) You selected: Correct

While administering medications to a group of clients admitted with anxiety, a nurse hears someone call for help. The nurse should respond by: locking the medication cart and responding to the call for help.

Explanation: A call for help in the hospital typically means a lifethreatening...(more) Explanation: A call for help in the hospital typically means a lifethreatening situation is occurring. Therefore, the nurse should

ensure the safety of the other clients by locking the medication cart and should then respond to the call for help. The nurse shouldn't assume that someone else will respond. The nurse shouldn't leave the client to whom she's administering medications until his safety is ensured. (less)

Question 12: (see full question) You selected: Correct

A client with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobias include: severe anxiety and fear.

Explanation: Phobias cause severe anxiety (such as a panic attack) that is out ...(more) Explanation: Phobias cause severe anxiety (such as a panic attack) that is out of proportion to the threat of the feared object or situation. Physical signs and symptoms of phobias include profuse sweating, poor motor control, tachycardia, and elevated blood pressure. Insomnia, an inability to concentrate, and weight loss are common in depression. Withdrawal and failure to distinguish reality from fantasy occur in schizophrenia. (less)

Question 13: (see full question)

A 49-year-old painter who recently fractured his tibia worries about his finances because he can't work. To treat his anxiety, his physician prescribes buspirone (BuSpar), 5 mg by mouth three times per day. During buspirone therapy, the client should avoid which of the following drugs? Monoamine oxidase (MAO) inhibitors

You selected: Correct

Explanation: Buspirone interacts only with MAO inhibitors, producing a hyperten...(more) Explanation: Buspirone interacts only with MAO inhibitors, producing a hypertensive reaction. Administration of betaadrenergic blockers, antineoplastic drugs, and antiparkinsonian drugs wouldn't cause an interaction, so they can be administered simultaneously with buspirone.

(less)

Question 14: (see full question)

A client is admitted to the psychiatric unit with a diagnosis of conversion disorder. Since witnessing the beating of his wife at gunpoint, he has been unable to move his arms, complaining that they are paralyzed. When planning the client's care, the nurse should focus on: helping the client identify and verbalize feelings about the incident.

You selected: Correct

Explanation: In conversion disorder, the client represses and converts emotiona...(more) Explanation: In conversion disorder, the client represses and converts emotional conflicts into motor, sensory, or visceral symptoms with no physiologic cause. Interventions should focus on helping the client identify the underlying emotional problem. A client with conversion disorder can't be convinced that the physical problem isn't real; attempts to convince him may lead him to seek other health care providers who may accept the reality of his symptoms. Treating the physical symptoms as longterm or permanent may encourage the client to maintain them. Ignoring the cause of the symptoms by changing the subject would prevent the client from dealing with his feelings about his wife's beating. (less)

Question 15: (see full question) You selected: Correct

Lorazepam (Ativan) is often given along with a neuroleptic agent, such as haloperidol (Haldol). What is the purpose of administering the drugs together? To reduce anxiety and potentiate the sedative action of the neuroleptic

Explanation: Lorazepam when given along with a neuroleptic such as haloperidol ...(more) Explanation: Lorazepam when given along with a neuroleptic such as haloperidol potentiates the sedating effect and is used to treat severely agitated clients. Haloperidol places the client at risk for extrapyramidal effects and, therefore, wouldn't be used to

treat extrapyramidal effects. Both drugs can cause depression, so they aren't used to treat depression. Concentration would be decreased because of the depressant effect. (less)

Question 17: (see full question)

A client with a conversion disorder reports blindness, and ophthalmologic examinations reveal that no physiologic disorder is causing progressive vision loss. The most likely source of this client's reported blindness is: having been forced to watch a loved one's torture.

You selected: Correct

Explanation: Conversion disorder, or hysterical neurosis, is characterized by a...(more) Explanation: Conversion disorder, or hysterical neurosis, is characterized by alteration or loss of physical function with no physiological basis; the client's symptoms result from psychological conflict. For example, a client may report blindness after having observed a distressing act, such as seeing a loved one tortured. None of the other options causes conversion disorder. (less)

Question 18: (see full question)

While driving home from work, a nurse realizes that she failed to communicate to the oncoming nurse that a client asked for more information about advance directives. Which action would be appropriate for the nurse to take? Phone the nurse caring for the client and inform her of the client's request.

You selected: Correct

Explanation: The off-duty nurse should phone the nurse caring for the client an...(more) Explanation: The off-duty nurse should phone the nurse caring for the client and inform her of the client's request for information. The nurse who is now caring for the client should provide the client with the advanced directive information supplied by the facility. The off-duty nurse doesn't need to return to work because she can inform the nurse caring for the client

over the phone. Providing the client with information the next morning might negatively affect the client's care if an emergency arises. The nurse shouldn't provide the client with information obtained over the Internet because it might be inaccurate and conflict with the facility's policy. Some facilities permit dispersing only teaching materials that are issued by the facility. (less)

Question 19: (see full question)

Before eating a meal, a client with obsessive-compulsive disorder (OCD) must wash his hands for 18 minutes, comb his hair 444 strokes, and switch the bathroom light on and off 44 times. What is the most appropriate goal of care for this client? Systematically decrease the number of repetitions of rituals and the amount of time spent performing them. Explanation: When caring for a client with OCD, the goal is to systematically d...(more) Explanation: When caring for a client with OCD, the goal is to systematically decrease the undesirable behavior. (Therapy may not completely extinguish certain behaviors.) Expecting to omit one behavior each day is unrealistic because the client may have used ritualistic behaviors to reduce anxiety for a long time. Drugs may become a source of obsession and must be used with caution. Allowing time for rituals would perpetuate the undesirable behaviors. (less)

Correct response:

Question 20: (see full question) You selected: Correct

The nurse is caring for a client with panic disorder who has difficulty sleeping. Which nursing intervention would best help the client achieve healthy long-term sleeping habits? Encouraging the use of relaxation exercises

Explanation: Relaxation exercises provide the client with a healthy way to gain...(more) Explanation: Relaxation exercises provide the client with a healthy way to gain control over anxiety. These exercises also produce a physiologic response opposite to that produced by stress. Giving a sleeping pill would provide short-term relief for sleeplessness but wouldn't teach healthy sleep habits. In addition,

clients can become dependent on sleeping aids. Suggesting that the client stay up and talk won't help him develop healthy sleep habits or control stress and anxiety. Playing ping-pong or engaging in other exercises just before sleep produces a physiologic response similar to stress. (less)

Question 1: (see full question)

A client with borderline personality disorder tells the nurse, "You're the only nurse who really understands me. The others are mean." The client then asks the nurse for an extra dose of antianxiety medication because of increased anxiety. How should the nurse respond? "I'll have to discuss your request with the team. Can we talk about how you're feeling right now?"

You selected: Correct

Explanation: This response appropriately focuses on the emotional content of th...(more) Explanation: This response appropriately focuses on the emotional content of the client's message and helps him identify his feelings. Focusing on the request for extra medication would allow the client to ignore the underlying emotional issues. Commonly, a client with borderline personality disorder divides the staff into "good guys" and "bad guys" to meet his needs; staff members must maintain consistency and a united front at all times. The nurse shouldn't take the client's statements personally because this would interfere with the ability to maintain a therapeutic relationship. (less)

Question 2: (see full question) You selected: Correct

During a panic attack, a client hyperventilates, becomes unable to speak, and reports symptoms that mimic those of a heart attack. Which nursing intervention would be best? Accompany the client to his room; remain there and provide instructions in short, simple statements.

Explanation: During a panic attack, interventions should focus on decreasing an...(more)

Explanation: During a panic attack, interventions should focus on decreasing anxiety. Therefore, the best nursing intervention is to stay with the client in a less stimulating environment, such as the client's room, and maintain a calm but direct and professional manner. Because the client feels flooded with stimuli during a panic attack, the nurse should remove the client from the milieu. The client also may tremble and have difficulty concentrating, so working on a craft project would be impossible. Being left alone could exacerbate panic symptoms. (less)

Question 3: (see full question)

A client, age 40, is admitted for a surgical biopsy of a suspicious lump in her left breast. When the nurse comes to take her to surgery, she is tearfully finishing a letter to her two children. She tells the nurse, "I want to leave this for my children in case anything goes wrong today." Which response by the nurse would be most therapeutic? "In case anything goes wrong? What are your thoughts and feelings right now?"

You selected: Correct

Explanation: By acknowledging how the client feels, this response encourages fu...(more) Explanation: By acknowledging how the client feels, this response encourages further expression of thoughts and feelings. Minimizing feelings or offering empty reassurances isn't therapeutic or helpful. Deep breathing and preoperative medication would be appropriate only after the client's fears have been expressed and dealt with. (less)

Question 4: (see full question)

While in the facility, a client with obsessive-compulsive disorder saves all used medicine cups and paper cups and arranges them in elaborate sculptures in the room. At home, the client saves mail and magazines and makes elaborate paper sculptures from them. Which outcome would indicate successful treatment for this client? The client throws away all disposable cups.

Correct response:

Explanation: With an obsessive-compulsive client, a goal of treatment is to thr...(more) Explanation: With an obsessive-compulsive client, a goal of treatment is to throw away hoarded items. Moving the hoarded items or rearranging them wouldn't indicate progress because these actions allow the inappropriate behavior to continue. (less)

Question 5: (see full question)

The nurse is formulating a short-term goal for a client suffering from a severe obsessive-compulsive disorder (OCD). An appropriately stated short-term goal is that after 1 week, the client will: participate in a daily exercise group.

You selected: Correct

Explanation: Participating in a daily exercise group refocuses the client's tim...(more) Explanation: Participating in a daily exercise group refocuses the client's time toward adaptive activities and may reduce anxiety. Option 1 isn't stated specifically enough to allow for evaluation. For this goal to be measurable, specific objectives must be stated such as, "The client will verbalize feeling less anxious." Option 3 is incorrect because identifying the underlying reasons for rituals takes time and isn't a realistic goal after 1 week. Most clients with OCD are aware that the ritual is irrational but can't stop it, making option 4 inappropriate as well. (less) Question 7: (see full question) A client diagnosed as having panic disorder with agoraphobia is admitted to the inpatient psychiatric unit. Until her admission, she had been a virtual prisoner in her home for 5 weeks, afraid to go outside even to buy food. When planning care for this client, what is the nurse's overall goal? To help the client function effectively in her environment Explanation: A client with panic disorder typically confines movements to incre...(more) Explanation: A client with panic disorder typically confines movements to increasingly smaller areas to avoid confronting fears, which may dominate the client's life and limit everyday activities. The overall goal of care is to help the client function

Correct response:

within the environment as effectively as possible. Panic disorder with agoraphobia doesn't impair the ability to perform self-care activities. Controlling symptoms isn't the overall goal; furthermore, helping the client function effectively will help control symptoms. Although participation in group therapy may help the client control symptoms, encouraging such participation isn't the overall goal of nursing care. (less)

Question 10: (see full question)

A client who recently developed paralysis of the arms is diagnosed with conversion disorder after tests fail to uncover a physical cause for the paralysis. Which intervention should the nurse include in the plan of care? Exercising the client's arms regularly

You selected: Correct

Explanation: To maintain the integrity of the affected areas and prevent muscle...(more) Explanation: To maintain the integrity of the affected areas and prevent muscle wasting and contractures, the nurse should help the client perform regular passive range-of-motion exercises with his arms. The nurse shouldn't insist that the client use his arms, such as by eating without assistance, because the client can't consciously control symptoms and move his arms. Also, such insistence may anger the client and endanger the therapeutic relationship. The nurse should include family members in the client's care because they may be contributing to the client's stress or conflict and are essential in helping the client regain function of his arms. The client isn't experiencing pain and, therefore, doesn't need education regarding pain management. (less)

Question 11: (see full question)

A client with a conversion disorder reports blindness, and ophthalmologic examinations reveal that no physiologic disorder is causing progressive vision loss. The most likely source of this client's reported blindness is: having been forced to watch a loved one's torture.

You selected: Correct

Explanation: Conversion disorder, or hysterical neurosis, is characterized by a...(more) Explanation: Conversion disorder, or hysterical neurosis, is characterized by alteration or loss of physical function with no physiological basis; the client's symptoms result from psychological conflict. For example, a client may report blindness after having observed a distressing act, such as seeing a loved one tortured. None of the other options causes conversion disorder. (less)

Question 12: (see full question) You selected: Correct

A client with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobias include: severe anxiety and fear.

Explanation: Phobias cause severe anxiety (such as a panic attack) that is out ...(more) Explanation: Phobias cause severe anxiety (such as a panic attack) that is out of proportion to the threat of the feared object or situation. Physical signs and symptoms of phobias include profuse sweating, poor motor control, tachycardia, and elevated blood pressure. Insomnia, an inability to concentrate, and weight loss are common in depression. Withdrawal and failure to distinguish reality from fantasy occur in schizophrenia. (less)

Question 13: (see full question)

While being escorted to an operating room, a client is extremely anxious and says, "I really don't know what they're going to do to me today. The physician said I have a lump in my breast and that's all I know." Which action is appropriate for the nurse to take? Notify the physician upon arrival at the operating room.

You selected: Correct

Explanation: The nurse should inform the physician, not just the operating room...(more) Explanation: The nurse should inform the physician, not just the operating room nurse, upon arrival at the operating room so that

he can further explain the surgery. The client shouldn't undergo surgery without being fully informed about the procedure and any potential complications associated with it. It's the responsibility of the physician performing the surgery, not the nurse, to inform the client about the procedure. The nurse doesn't have the authority to cancel the procedure. The procedure shouldn't be cancelled unless the client has already received sedation without being fully informed. (less)

Question 14: (see full question)

The nurse in a psychiatric inpatient unit is caring for a client with obsessive- compulsive disorder. As part of the client's treatment, the psychiatrist orders lorazepam (Ativan), 1 mg by mouth three times per day. During lorazepam therapy, the nurse should remind the client to: avoid caffeine. Explanation: Ingesting 500 mg or more of caffeine can significantly alter the a...(more) Explanation: Ingesting 500 mg or more of caffeine can significantly alter the anxiolytic effects of lorazepam. Other dietary restrictions are unnecessary. Staying out of the sun or using sunscreens is required when taking phenothiazines. An adequate salt intake is necessary for clients receiving lithium. (less)

Correct response:

Question 15: (see full question) Correct response:

During alprazolam (Xanax) therapy, the nurse should be alert for which dose- related adverse reaction? Ataxia Explanation: Dose-related adverse reactions to alprazolam include drowsiness, c...(more) Explanation: Dose-related adverse reactions to alprazolam include drowsiness, confusion, ataxia, weakness, dizziness, nystagmus, vertigo, syncope, dysarthria, headache, tremor, and a glassy-eyed appearance. These dose-related reactions diminish as therapy continues. Although hepatomegaly may occur with benzodiazepine use, this adverse reaction is rare and isn't doserelated. Idiosyncratic reactions to benzodiazepines may include a rash and acute hypersensitivity reactions; however, they aren't

dose-related. (less)

Question 16: (see full question)

A 49-year-old painter who recently fractured his tibia worries about his finances because he can't work. To treat his anxiety, his physician prescribes buspirone (BuSpar), 5 mg by mouth three times per day. During buspirone therapy, the client should avoid which of the following drugs? Monoamine oxidase (MAO) inhibitors

You selected: Correct

Explanation: Buspirone interacts only with MAO inhibitors, producing a hyperten...(more) Explanation: Buspirone interacts only with MAO inhibitors, producing a hypertensive reaction. Administration of betaadrenergic blockers, antineoplastic drugs, and antiparkinsonian drugs wouldn't cause an interaction, so they can be administered simultaneously with buspirone. (less)

Question 17: (see full question) You selected: Correct

During the client-teaching session, which instruction should the nurse give to a client receiving alprazolam (Xanax)? "Inform the physician if you become pregnant or intend to do so."

Explanation: Because alprazolam is contraindicated during pregnancy, the client...(more) Explanation: Because alprazolam is contraindicated during pregnancy, the client should be instructed to inform the physician if she becomes pregnant. Nausea, urine retention, and photosensitivity are adverse reactions that may occur with alprazolam use, not contraindications. (less)

Question 18:

A client tells the nurse that she has an overwhelming fear of

(see full question) Correct response:

having a heart attack. This client is most likely suffering from which disorder? Panic disorder Explanation: Anxiety severe enough to cause the client to fear a heart attack i...(more) Explanation: Anxiety severe enough to cause the client to fear a heart attack is characteristic of panic disorder. Social phobia is characterized by a dread of being scrutinized and embarrassed in public. In generalized anxiety disorder, anxiety is persistent, overwhelming, uncontrollable, and out of proportion to the stimulus. Myctophobia is the fear of the dark. (less)

Question 19: (see full question) You selected: Correct

A client comes to the emergency department while experiencing a panic attack. The nurse should respond to a client having a panic attack by: staying with the client until the attack subsides.

Explanation: The nurse should remain with the client until the attack subsides....(more) Explanation: The nurse should remain with the client until the attack subsides. If the client is left alone, he may become more anxious. Giving false reassurance is inappropriate in this situation. The client should be allowed to move around and pace to help expend energy. The client may be so overwhelmed that he can't follow lengthy explanations or instructions, so the nurse should use short phrases and slowly give one direction at a time. (less)

Question 20: (see full question) You selected: Correct

A physician's order states to administer lorazepam (Ativan), 20 mg by mouth twice per day, to treat anxiety. How should the nurse proceed? Clarify the order with the prescribing physician because the amount prescribed exceeds the recommended dose.

Explanation: The recommended dosage of lorazepam for treatment of anxiety is 1 ...(more) Explanation: The recommended dosage of lorazepam for treatment of anxiety is 1 to 10 mg, given in divided doses two to three times per day. The nurse should clarify the order with the prescribing physician because it exceeds the recommended dosage. The liquid form of the drug, not the tablet form, should be added to 30 ml of a diluent before administration. (less)

Question 2: (see full question) You selected: Correct

Because antianxiety agents such as lorazepam (Ativan) can potentiate the effects of other drugs, the nurse should incorporate which instruction in her teaching plan? Avoid mixing antianxiety agents with alcohol or other central nervous system (CNS) depressants.

Explanation: Potentiating effect refers to a drug's ability to increase the pot...(more) Explanation: Potentiating effect refers to a drug's ability to increase the potency of another drug if taken together. Therefore, the client should be instructed to avoid alcohol while taking lorazepam because it potentiates the drug's CNS depressant effect. Taken at bedtime, this drug will induce sleep. Lorazepam comes in tablet form and usually can be taken with water. Aged cheese is restricted with monoamine oxidase inhibitors, not lorazepam. (less)

Question 3: (see full question) You selected: Correct

A client is admitted to an inpatient psychiatric unit for treatment of obsessive-compulsive symptoms. Obsessive-compulsive disorder (OCD) is associated with: repetitive thoughts and recurring, irresistible impulses.

Explanation: OCD is characterized by repetitive thoughts that the client can't ...(more) Explanation: OCD is characterized by repetitive thoughts that the client can't control or exclude from consciousness, along with recurring, irresistible impulses to perform a particular action.

Physical signs and symptoms with no physiologic cause typify somatoform disorder. Apprehension and inability to concentrate characterize anxiety disorders. (less)

Question 4: (see full question) You selected: Correct

The nurse notices that a client with obsessive-compulsive disorder washes his hands for long periods each day. How should the nurse respond to this compulsive behavior? By designating times during which the client can focus on the behavior

Explanation: The nurse should designate times during which the client can focus...(more) Explanation: The nurse should designate times during which the client can focus on the compulsive behavior or obsessive thoughts. The nurse should urge the client to reduce the frequency of the compulsive behavior gradually, not rapidly. She shouldn't call attention to or try to prevent the behavior. Trying to prevent the behavior may cause pain and terror in the client. The nurse should encourage the client to verbalize his anxieties to help distract his attention from the compulsive behavior. (less)

Question 5: (see full question)

A client in a psychiatric facility is prescribed escitalopram (Lexapro) for anxiety. She tells the nurse that she has been having "weird dreams" and feelings of wanting to "end it all." What action should the nurse take? Consult a pharmacist to see if these symptoms are adverse effects of the drug.

You selected: Correct

Explanation: The nurse should consult a pharmacist to determine if the client's...(more) Explanation: The nurse should consult a pharmacist to determine if the client's symptoms are adverse effects of the drug. It isn't necessary for the nurse to activate the emergency medical system because the client shows no signs of requiring immediate intervention. It isn't necessary to inquire about the details of the

dreams. The nurse should find out more information about the drug instead of falsely reassuring the client that her symptoms will disappear. (less) perf You selected: Correct Explanation: Escorting the client to a quiet area and suggesting the use of a r...(more) Explanation: Escorting the client to a quiet area and suggesting the use of a relaxation technique helps the client gain control of his symptoms and provides support and feedback. Encouraging the client to discuss the cause of anxiety, as in option 1, only increases the symptoms. Option 2 isn't the best initial action because antianxiety medications don't take effect immediately. The client may become more anxious if left alone, as in option 4. (less) escort the client to a quiet area and suggest using a relaxation exercise that he's been taught.

Question 12: (see full question)

A 59-year-old client is scheduled for cardiac catheterization the next morning. His physician prescribed secobarbital sodium (Seconal), 100 mg by mouth at bedtime, for sedation. Before administering the drug, the nurse should know that: sedatives reduce excitement; hypnotics induce sleep.

You selected: Correct

Explanation: Sedatives are drugs that act to reduce activity or excitement, cal...(more) Explanation: Sedatives are drugs that act to reduce activity or excitement, calming a client. Administered in large doses, sedatives act as hypnotics, which induce a state resembling natural sleep. (less)

Question 13:

A client is diagnosed with obsessive-compulsive disorder. Which

(see full question) You selected: Correct

intervention should the nurse include when assisting with development of the plan of care? Giving the client adequate time to perform rituals

Explanation: The nurse should give the client adequate time to perform rituals ...(more) Explanation: The nurse should give the client adequate time to perform rituals because this reduces anxiety. The other options would increase the client's anxiety. (less) Question 16: (see full question) You selected: Correct Explanation: Buspirone is the most appropriate medication for this client becau...(more) Explanation: Buspirone is the most appropriate medication for this client because of its antianxiety properties. Benztropine is an antiparkinsonian agent used to control the extrapyramidal effects of such antipsychotic agents as chlorpromazine hydrochloride and thioridazine hydrochloride. Chlorpromazine is used to control the severe symptoms (hallucinations, thought disorders, and agitation) seen in clients with psychosis. Clozapine is used to manage symptoms of schizophrenia in clients who don't respond to other antipsychotic drugs. (less) The nurse refers a client with severe anxiety to a psychiatrist for medication evaluation. The physician is most likely to prescribe which psychotropic drug regimen for this client? Buspirone (BuSpar), 5 mg orally three times per day

Question 17: (see full question)

The nurse is caring for a Vietnam War veteran with a history of explosive anger, unemployment, and depression since being discharged from the service. The client reports feeling ashamed of being "weak" and of letting past experiences control thoughts and actions in the present. What is the nurse's best response? "Many people who have been in your situation experience similar emotions and behaviors." Explanation: By providing reassurance that extreme anger and

Correct response:

other reactions ar...(more) Explanation: By providing reassurance that extreme anger and other reactions are normal responses to trauma, the nurse assists the client to deal with the shame over a perceived lack of control over feelings and to gain confidence in the ability to alter behaviors. Responses such as those in options 2, 3, and 4 are clichs and don't address the client's feelings. (less)

Question 18: (see full question) You selected: Correct

Which nursing intervention would be most helpful for a client experiencing a panic attack? Staying with the client and remaining calm, confident, and reassuring

Explanation: A panic-stricken client requires the assistance of a calm person w...(more) Explanation: A panic-stricken client requires the assistance of a calm person who can provide support and direction. This is particularly important because the client already feels frightened and out of control. Having someone remain with the client helps prevent feelings of isolation and desertion. Encouraging the client to identify what precipitated the attack is futile because the client is too anxious to focus on the precipitating factors. Interacting with others is difficult for an extremely anxious person. Reducing stimuli may be helpful but having the client stay alone may increase anxiety. (less)

Question 20: (see full question) You selected: Correct

The nurse discovers that a client with obsessive-compulsive disorder (OCD) is attempting to resist the compulsion. Based on this finding, the nurse should look for signs of: increased anxiety.

Explanation: An obsessive-compulsive client who attempts to resist the compulsi...(more) Explanation: An obsessive-compulsive client who attempts to resist the compulsion must be evaluated for increased anxiety. A

compulsion is a repetitive, intentional behavior that the client performs in response to a certain obsession; it's aimed at neutralizing or decreasing anxiety. Resisting the compulsion may increase the client's anxiety. Although a client with OCD may have feelings of failure, depression, and excessive fear, these aren't responses to resisting the compulsion. (less)