Proctored Review Questions

Agnosia

the inability to recognize familiar objects.

A nurse is caring for a client who has Alzheimer's disease and a new prescription for donepezil. Which of the following actions should the nurse take? • A. Monitor the client's liver function while taking this medication • B. Increase the dosage of this medication every 72 hr • C. Offer the client a PRN NSAID while taking this medication • D. Administer the medication at bedtime

• D. Administer the medication at bedtime Donepezil is used to treat the manifestations of mild to moderate Alzheimer's disease. The nurse should administer this medication at bedtime to reduce the risk of injury due to bradycardia and syncope.

A nurse on an inpatient mental health unit is attending an interdisciplinary treatment team meeting for a client who has bipolar disorder with rapid cycling. The client is being prepared for discharge following his fourth admission in the last year. Which of the following referrals should the nurse make for the client first? • A. Assertive community treatment • B. Support group • C. Private counseling • D. Vocational rehabilitation services

A. Assertive community treatment Evidence-based practice indicates the nurse should first refer the client to an assertive community treatment (ACT). An ACT program should be most beneficial for this client who has bipolar disorder with rapid cycling, as professional help will be available to the client 24 hours a day for crisis management. A multidisciplinary team approach assists clients in managing their mental illness so inpatient hospitalizations can be avoided.

A nurse on an acute care unit is providing postoperative care to an older adult client who develops delirium. Which of the following actions should the nurse take? A. Request a prescription for an antianxiety medication B. Provide the client with a stimulating activity prior to bedtime C. Dim the lights in the client's room at night D. Encourage the client to make decisions about her daily routine

A. Request a prescription for an antianxiety medication The nurse should request a prescription for an antianxiety medication for a client who develops delirium. Administration of a PRN antianxiety medication can decrease anxiety and agitation. Thr nurse should keep lights well lit

A nurse is observing a client who has histrionic personality disorder. Which of the following behaviors should the nurse expect? • A. The client whispers in the provider's ear • B. The client refuses to provide her telephone number • C. The client has diminished facial expressions • D. The client asks if she is doing the right thing 3 times during the appointment

A. The client whispers in the provider's ear Acting provocatively and seductively is an expected behavior of an individual with histrionic personality disorder.

A nurse is caring for a client who has Alzheimer's disease. The client's adult son states the client has begun wandering away from her home. Which of the following responses should the nurse offer? • A. "You should plan to move your mother into your home soon." • B. "Place a complex lock at the top of each door that leads outside." • C. "It is time to place your mother in a long-term care facility." • D. "Have you reminded your mother about the dangers of wandering away from home?"

B. "Place a complex lock at the top of each door that leads outside." The nurse should instruct the client's son to place complex locks at the top of doors that lead outside to prevent the client from wandering away from home. The nurse should also encourage the client's son to place a nonremovable medical alert bracelet on the client that includes the client's name, address, and telephone number.

A nurse is providing teaching to a client who has a new prescription for diazepam. Which of the following instructions should the nurse include in the teaching? • A. "Expect this medication to make you feel anxious." • B. "This medication can be habit-forming." • C. "Take this medication on an empty stomach." • D. "This medication needs to be taken for 2 to 3 weeks to reach the full therapeutic effect."

B. "This medication can be habit-forming." Diazepam is a benzodiazepine agent. All drugs in this category can cause physical dependence and are considered controlled substances.

A nurse is assessing a client who has an anxiety disorder and is taking a benzodiazepine. For which of the following adverse effects should the nurse monitor the client? •A. Seizures •B. Dizziness •C. Polyuria •D. Insomnia

B. Dizziness Dizziness is a common adverse effect of benzodiazepines. Other common adverse effects are drowsiness and sedation.

A nurse is caring for a newly admitted client who is receiving treatment for alcohol use disorder. The client tells the nurse, "l have not had anything to drink for 6 hours." Which of the following findings should the nurse expect during alcohol withdrawal? A. Low body temperature B. Insomnia C. Muscle flaccidity D. Bradycardia

B. Insomnia The nurse should expect a client who is experiencing alcohol withdrawal to have insomnia and restlessness.

A nurse is providing teaching to a client who has a new prescription for disulfiram for the management of alcohol dependence. Which of the following dietary items should the nurse instruct the client to avoid? • A. Peppermint candy • B. Pure vanilla extract • C. Salt • D. Chocolate

B. Pure vanilla extract The nurse should instruct the client to avoid alcohol and alcohol-containing substances such as pure vanilla extract while taking disulfiram. The ingestion of alcohol while taking this medication causes a disulfiram-alcohol reaction, which is manifested by hyperventilation, dizziness, vomiting, and hypotension.

A nurse is speaking to a community group about the diagnosis and treatment of clients who have Alzheimer's disease. The nurse should conclude that the group requires further teaching when a member identifies which of the following findings as a manifestation of Alzheimer's disease? • A. Impaired judgment • B. Sudden confusion • C. Personality change • D. Remote memory loss

B. Sudden confusion The nurse should clarify that a client who has Alzheimer's disease is expected to exhibit confusion that develops slowly over months. Clients who have delirium exhibit sudden confusion.

A nurse is caring for a client who is receiving cognitive-behavioral therapy. The client tells the nurse, "Nothing good ever happened during my marriage." When using cognitive reframing, which of the following responses should the nurse offer? A. "Let's discuss what you consider to be negative about your marriage." B. "What activities take your mind off of your marriage experience?" C. "What did you learn from your marriage to help you in the future?" D. "Only you can understand how your marriage negatively affected your life."

C. "What did you learn from your marriage to help you in the future?" Cognitive-behavioral therapy, specifically cognitive reframing, asks the client to restructure thoughts to learn from situations perceived as negative. The intended purpose is to help the client identify misperceptions and work toward developing more accurate and positive perceptions. This response encourages the client to regard the situation with a more positive outlook to find the benefits of the experience.

A nurse is creating a plan of care for a client who has Alzheimer's disease with moderate cognitive decline. Which of the following interventions should the nurse include to orient the client to the present? • A. Discourage the client from reminiscing about the past. • B. Overlook the client's frustration with communication. • C. Talk with the client about scheduled daily activities. • D. Present multiple options when offering the client choices.

C. Talk with the client about scheduled daily activities. Discussing scheduled daily activities assists in orienting the client to time and reality throughout the day.

A nurse is assessing a client who has ADHD and reports abruptly discontinuing his amphetamine treatment. Which of the following assessments indicates that the client is physically dependent on the amphetamines? A. The client exhibits paranoia B. The client reports having insomnia C. The client reports eating excessively D. The client has an increased heart rate

C. The client reports eating excessively When amphetamine is taken at a therapeutic dose, it causes appetite suppression. Abrupt withdrawal of amphetamine can result in abstinence syndrome in a client who is physically dependent on the medication. Indications of physical dependence include excessive eating, exhaustion, depression, prolonged sleep, and a craving for more amphetamine.

benzodiazepine

CNS depressing agents with the potential for abuse and/or dependence Ex. Flumazenil, Diazepan

A nurse at a long-term care facility hears an assistive personnel (AP) talking with an older adult client who has dementia with periods of confusion. Which of the following statements should indicate that the AP requires further teaching? A. "We will be serving breakfast in 10 min. I will stay here while you get ready." B. "It's Monday morning. I know that your favorite television shows are on this evening." C. "l see that you have a new photo on the wall. Can you tell me who that girl is?" D. "It's almost time for your appointment. Let me do your hair for you and brush your teeth."

D. "It's almost time for your appointment. Let me do your hair for you and brush your teeth." When a client with dementia has periods of confusion, the AP should give the client additional time to complete activities that can be performed independently. Insisting on completing the task or attempting to hurry the client can provoke agitation. The AP should encourage independence and provide assistance only if the client asks for or truly needs it.

A nurse is caring for a client who has Alzheimer's disease and a new prescription for donepezil. Which of the following actions should the nurse take? A. Monitor the client's liver function while taking this medication B. Increase the dosage of this medication every 72 hr C. Offer the client a PRN NSAID while taking this medication D. Administer the medication at bedtime

D. Administer the medication at bedtime Donepezil is used to treat the manifestations of mild to moderate Alzheimer's disease. The nurse should administer this medication at bedtime to reduce the risk of injury due to bradycardia and syncope.

A nurse is providing teaching to a client who has a new prescription for amitriptyline The nurse should teach the client that which of the following over-the-counter medications can cause cardiac dysrhythmias when taken concurrently with amitriptyline? A. Acetaminophen B. Famotidine C. Naproxen D. Pseudoephedrine

D. Pseudoephedrine Pseudoephedrine interacts with tricyclic medications and is therefore contraindicated. Ingesting products containing ephedrine along with amitriptyline can cause cardiac dysrhythmias.

Apraxia

inability to perform particular purposive actions or motor ability, as a result of brain damage.

Moslow's Hierarchy of Needs

physiological needs security and safety belonging and love esteem needs self- actualizations

perservation

state of repeatedly performing the same segment of a task or repeatedly saying the same word/phrase without purpose

Confabulation

the act of filling in memory gaps by lying ex. a nurse asks a client if he had any visitors and the client says many when it was just his daughter.