3554 Module 4 Slidos

Cardiomyopathy & ED

myocardium enlarges from loss of electrolytes & heart pumps harder from poor muscle weakness

Why is dental care important with ED?

Vomiting hurts teeth from acid

Drug for eating disorder (ED)

Prozac

Anorexia symptoms

-hyponatremia -low BP

A client diagnosed with anorexia nervosa virtually stopped eating 5 months ago. A nurse asks, "Describe what you think about your present weight and how you look." Which response by the client is most consistent with the diagnosis? A. "I am fat and ugly." B. "What I think about myself is my business." C. "I'm grossly underweight, but that's what I want." D. "I'm a few pounds' overweight, but I can live with it."

A. "I am fat and ugly."

Four new clients were admitted to the behavioral health unit in the past 12 hours. The nurse directs a psychiatric technician to monitor these clients for safety. Which client diagnosis will need the most watchful supervision? A. Bipolar 1 B. Bipolar 11 C. dysthymic disorder. D. cyclothymic disorder.

A. Bipolar 1

A nurse assesses a client who takes lithium. Which findings demonstrate evidence of complications? A. Diaphoresis, weakness, and nausea B. pharyngitis, dilated pupils, and dystonia C. Alopecia, ecchymoses, and drowsiness D. Ascites, dyspnea, and edema

A. Diaphoresis, weakness, and nausea

What are the most therapeutic characteristics for a nurse working with a client beginning treatment for alcohol addiction to present? A. Empathetic, supportive B. skeptical, guarded C. Cool, distant D. Confrontational

A. Empathetic, supportive

Which suggestions are appropriate for the family of a client diagnosis. A. Limit credit card access. B. Provide a structured environment. C. Encourage group social interaction. D. Supervise medication administration. E. Monitor the client's sleep patterns.

A. Limit credit card access. B. Provide a structured environment. D. Supervise medication administration. E. Monitor the client's sleep patterns.

Which features should be present in a therapeutic milieu for a client experiencing a hallucinogen overdose? A. Simple and safe B. Active and bright C. Stimulating and colorful D. Confrontational and challenging

A. Simple and safe

When a client first began using alcohol, two drinks produced relaxation and drowsiness. After 1 year, four drinks are needed to achieve the same response. Why has this change occurred? A. Tolerance has developed. B. Compatibility effects are evident. C. Metabolism of the alcohol is now delayed. D. Pharmacokinetics of the alcohol have changed

A. Tolerance has developed.

A client diagnosed with bipolar disorder who takes lithium carbonate 300 mg three times daily reports nausea. To reduce the nausea most effectively, the nurse suggests that the lithium be taken with what? A. food. B. an antacid. C. an antiemetic. D. a large glass of juice.

A. food

A health teaching plan for a client taking lithium should include which instructions? A. maintain normal salt and fluids in the diet. B. drink twice the usual daily amount of fluid. C. double the lithium dose if diarrhea or vomiting occurs. D. avoid eating aged cheese, processed meats, and red wine

A. maintain normal salt and fluids in the diet.

The nurse receives a laboratory report indicating a client's serum level is 1 mEq/L. The client's last dose of lithium was 8 hours ago. What does this result indicate? A. within therapeutic limits B. below therapeutic limits. C. above therapeutic limits. D. invalid because of the time lapse since the last dose.

A. within therapeutic limits

A client diagnosed with acute mania has disrobed in the hall three times in 2 hours. What intervention should the nurse implement? A. direct the client to wear clothes at all times. B. ask if the client finds clothes bothersome. C. tell the client that others feel embarrassed. D. arrange for one-on-one supervision

D. arrange for one-on-one supervision

The spouse of a client diagnosed with bipolar disorder asks what evidence supports the possibility of genetic transmission of bipolar disorders. Which response should the nurse provide? A. "A high proportion of clients with bipolar disorders are found among creative writers." B. "A higher rate of relatives with bipolar disorder is found among clients with bipolar disorder." C. "Clients with bipolar disorder have higher rates of relatives who respond in an exaggerated way to daily stress." D. "More individuals with bipolar disorder come from high socioeconomic and educational backgrounds."

B. "A higher rate of relatives with bipolar disorder is found among clients with bipolar disorder."

Client asks for information about alcoholics anonymous (AA). What is the nurse's best response? A. "AA is a form of group therapy led by a psychiatrist." B. "AA is a self-help group for which the goal is sobriety." C. "AA is a group that learns about drinking from a group leader." D. "AA is a network that advocates strong punishment for drunk drivers."

B. "AA is a self-help group for which the goal is sobriety."

A Client diagnosed with alcohol use disorder asks, "How will Alcoholics Anonymous (AA) help me?" What is the nurse's best response? A. "The goal of AA is for members to learn controlled drinking with the support of a higher power." B. "An individual is supported by peers while striving for abstinence one day at a time." C. "You must make a commitment to permanently abstain from alcohol and other drugs." D. "You will be assigned a sponsor who will plan your treatment program."

B. "An individual is supported by peers while striving for abstinence one day at a time."

A client diagnosed with bipolar disorder is in the maintenance phase of treatment. The client asks, "Do I have to keep taking this lithium even though my mood is stable now?" What is the nurse's most appropriate response? A. "You will be able to stop the medication in about 1 month." B. "Taking the medication every day helps reduce the risk of a relapse." C. "Most clients take medication for approximately 6 months after discharge." D. "It's unusual that the health care provider hasn't already stopped your medication."

B. "Taking the medication every day helps reduce the risk of a relapse."

A client demonstrating behaviors associated with acute mania has exhausted the staff by noon. Staff members are feeling defensive and fatigued. Which action will the staff take initially? A. Confer with the health care provider to consider use of seclusion for this client. B. Hold a staff meeting to discuss consistency and limit-setting approaches. C. Conduct a meeting with all staff and clients to discuss the behavior. D. Explain to the client that the behavior is unacceptable.

B. Hold a staff meeting to discuss consistency and limit-setting approaches.

A nurse wants to teach alternative coping strategies to a client experiencing severe anxiety. Which action should the nurse perform first? A. Verify the client's learning style. B. Lower the client's current anxiety C. Create outcomes and a teaching plan. D. Assess how the client uses defense mechanisms.

B. Lower the client's current anxiety

A nurse cares for a client experiencing an opioid overdose. Which focused assessment has the highest priority? A. Cardiovascular B. Respiratory C. Neurological D. Hepatic

B. Respiratory

A client experiencing acute mania is dancing atop a pool table in the recreation room. The client waves a cue in one hand and says, "I'll throw the pool balls if anyone comes near me." To best assure safety, what is the nurse's first intervention? A. tell the client, "You need to be secluded." B. clear the room of all other clients C. help the client down from the table. D. assemble a show of force.

B. clear the room of all other clients

A client diagnosed with bipolar is prescribed lithium. The client telephones the nurse "I've had severe diarrhea for 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse." What advise will the nurse give to the client? A. restrict food and fluids for 24 hours and stay in bed. B. have someone bring the client to the clinic immediately. C. drink a large glass of water with 1 teaspoon of salt added. D. take one dose of an over-the-counter antidiarrheal medication now.

B. have someone bring the client to the clinic immediately.

A client waves a newspaper and says, "I must have my credit card and use the computer right now. A store is having a big sale, and I need to order 10 dresses and four pairs of shoes." What is the nurse's appropriate intervention? A. suggesting the client have a friend do the shopping and bring purchases to the unit. B. inviting the client to sit together and look at new fashion magazines. C. telling the client computer use is not allowed until self-control improves. D. asking whether the client has enough money to pay for the purchases.

B. inviting the client to sit together and look at new fashion magazines.

Which symptoms of withdrawal from opioids should the nurse assess for? A. dilated pupils, tachycardia, elevated blood pressure, and elation. B. nausea, vomiting, diaphoresis, watery eyes C. mood lability, incoordination, fever D. excessive eating, constipation, and headache.

B. nausea, vomiting, diaphoresis, watery eyes

A client referred to the eating disorders clinic has lost 35 pounds during the past 3 months. To assess eating patterns, the nurse should ask the client which question? A. "Do you often feel fat?" B. "Who plans the family meals?" C. "Can you tell me on a typical day your meal plan?" D. What do you think about your present weight?"

C. "Can you tell me on a typical day your meal plan?"

The past year, a client has cooked gourmet meals for the family but eats only tiny servings. This person wears layered loose clothing and currently weighs 95 pounds, after a loss of 35 pounds. Which medical diagnosis is most likely? A. Binge eating B. Bulimia nervosa C. Anorexia nervosa D. Eating disorder not otherwise specified

C. Anorexia nervosa

Which dinner menu is best suited for a client with acute mania? A. Spaghetti and meatballs, salad, and a banana B. Beef and vegetable stew, a roll, and chocolate pudding C. Broiled chicken breast on a roll, an ear of corn, and an apple D. Chicken casserole, green beans, mashed potatoes

C. Broiled chicken breast on a roll, an ear of corn, and an apple

The plan of care for a client in the manic state of bipolar disorder should include which interventions? (Select all that apply.) A. Touch the client to provide reassurance. B. Invite the client to lead a community meeting. C. Provide a structured environment for the client D. Ensure that the client's nutritional needs are met. E. Design activities that require the client's concentration.

C. Provide a structured environment for the client D. Ensure that the client's nutritional needs are met.

A client sustained injuries while intoxicated is now hospitalized. The client is now shaky, irritable, anxious, diaphoretic, and reports nightmares. The client shouts, "Bugs are crawling on my bed. I've got to get out of here." What is your assessment? A. The client is attempting to obtain attention by manipulating staff. B. The client may have sustained a head injury before admission. C. The client has symptoms of alcohol withdrawal delirium. D. The client is having an acute psychosis.

C. The client has symptoms of alcohol withdrawal delirium.

A client diagnosed with bipolar disorder has rapidly changing mood cycles. The health care provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug should the nurse anticipate will be prescribed? A. risperidone B. phenytoin C. carbamazepine D. Haldol

C. carbamazepine

A client experiencing acute mania undresses in the group room and dances. How should the nurse intervene initially? A. quietly asking the client, "Why don't you put your clothes on?" B. firmly telling the client, "Stop dancing and put on your clothing." C. putting a blanket around the client and walking with the client to a quiet room. D. letting the client stay in the group room and moving the other clients to a different area.

C. putting a blanket around the client and walking with the client to a quiet room.

Russell thumb sign

Comes from self induced vomiting

A client diagnosed with alcohol use disorder says, "Drinking helps me cope with being a single parent." Which therapeutic response by the nurse would help the client conceptualize the drinking objectively? A. "Sooner or later, alcohol will kill you. Then what will happen to your children?" B. "I hear a lot of defensiveness in your voice. Do you really believe this?" C. "If you were coping so well, why were you hospitalized again?" D. "Tell me what happened the last time you drank."

D. "Tell me what happened the last time you drank."

The nursing care plan for a client diagnosed with anorexia nervosa includes the intervention "monitor for complications of refeeding." Which system should a nurse closely monitor for dysfunction? A. Renal B. Endocrine C. Integumentary D. Cardiovascular

D. Cardiovascular

Which assessment findings are likely for an individual who recently injected heroin? A. Anxiety, restlessness, paranoid delusions B. Muscle aching, dilated pupils, tachycardia C. Heightened sexuality, insomnia, euphoria D. Drowsiness, constricted pupils, slurred speech

D. Drowsiness, constricted pupils, slurred speech

A client newly diagnosed with bipolar disorder is prescribed lithium. Which information from the client's medical history indicates that monitoring of serum concentrations of the drug will be challenging and critical? A. Arthritis B. Epilepsy C. Psoriasis D. Heart failure

D. Heart failure

A client was diagnosed with anorexia nervosa. The history shows the client virtually stopped eating 5 months ago and lost 25% of body weight. The serum potassium is currently 2.7 mg/dL. Which nursing diagnosis applies? A. Adult failure to thrive related to abuse of laxatives as evidenced by electrolyte imbalances and weight loss B. Disturbed energy field related to physical exertion in excess of energy produced through caloric intake as evidenced by weight loss and hyperkalemia C. Ineffective health maintenance related to self-induced vomiting as evidenced by swollen parotid glands and hyperkalemia D. Imbalanced nutrition: less than body requirements related to reduced oral intake as evidenced by loss of 25% of body weight and hypokalemia

D. Imbalanced nutrition: less than body requirements related to reduced oral intake as evidenced by loss of 25% of body weight and hypokalemia

Which assessment data confirm the suspicion that a patient is experiencing opioid withdrawal? A. Pupils are dilated B. Pulse rate is 62 beats/min. C. Slow movements D. Rhinorrhea

D. Rhinorrhea

A client admitted yesterday for injuries sustained while intoxicated believes insects are crawling on the bed. A. Disturbed sensory perception B. Ineffective coping C. Ineffective denial D. Risk for injury

D. Risk for injury