Dynamic quizzes study w/ rationales (hard)

A nurse is reviewing laboratory reports for a client who is taking risperidone. The nurse should identify that which of the following results indicates a potential adverse reaction to the medication? A. Elevated blood glucose B. Elevated WBC count C. Decreased platelet count D. Decreased aspartate transaminase (AST)

A. Elevated blood glucose

A nurse is planning reminiscence therapy for an older adult client. The nurse should identify which of the following goals for this therapy? A. The client will gain increased self-esteem. B. The client will maintain orientation to place and time. C. The client will independently perform ADLs. D. The client will achieve optimal sensory stimulation.

A. The client will gain increased self-esteem.

A nurse in a provider's office is reviewing the medical history of a client who asks about the use of varenicline for smoking cessation. Which of the following items in the client's medical history indicates a precaution for the use of varenicline? A. The client has type I diabetes mellitus B. The client has a history of depression C. The client has rheumatoid arthritis D. The client has a history of GERD

B. The client has a history of depression

A nurse is evaluating teaching for a client who has bipolar disorder and a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching? A. "I should take lithium on an empty stomach." B. "I can take ibuprofen for headaches while taking lithium." C. "I need to limit my salt intake while taking lithium." D. "I am likely to gain weight while taking lithium."

D. "I am likely to gain weight while taking lithium."

A nurse is caring for a client who has anorexia nervosa. The client states, "If I gain weight, I'll never get a boyfriend." Which of the following cognitive distortions is the client displaying? A. Overgeneralization B. Personalization C. Emotional reasoning D. Catastrophizing

D. Catastrophizing rationale: A client displays the cognitive distortion of catastrophizing by assuming the worst possible outcomes will occur. A. A client displays the cognitive distortion of overgeneralization when he uses one, or a few, unfortunate events as proof that things will never go right again. B. A client displays the cognitive distortion of personalization by assuming responsibility for a situation that was not within the client's control. C. A client displays the cognitive distortion of emotional reasoning by making decisions based on the client's emotional state.

A nurse is monitoring a client who has schizophrenia and is receiving treatment with fluphenazine hydrochloride. Which of the following findings is an indication of neuroleptic malignant syndrome that the nurse should report to the provider? A. Blurred vision B. Urinary retention C. Muscle flaccidity D. Elevated temperature

D. Elevated temperature

A nurse is assessing a client who has panic disorder and has been taking paroxetine. Which of the following assessments should the nurse identify as an adverse effect of the medication? A. Peripheral edema B. Chest congestion C. Shuffling gait D. Weight gain

D. Weight gain

A nurse is providing dietary teaching to a client who has a new prescription for a monoamine oxidase inhibitor (MAOI). Which of the following food selections by the client indicates an understanding of the teaching? A. Cheddar cheese B. Avocados C. Pepperoni D. Yogurt

D. Yogurt

A nurse is providing teaching to a client who has anxiety and a new prescription for diazepam. Which of the following statements should the nurse make? A. "Feelings of sedation should resolve in about 1 week." B. "There is no risk of physical dependence with this medication." C. "You can increase the dose when you feel especially anxious." D. "It will take several months for you to feel the maximum benefit of the medication."

A. "Feelings of sedation should resolve in about 1 week."

A nurse is performing a mental status assessment on an older adult client who has dementia. Which of the following questions should the nurse ask to assess the client's remote memory? A. "In what year did you graduate from high school?" B. "What is your favorite childhood memory?" C. "What did you have for supper yesterday?" D. "What is today's date?"

A. "In what year did you graduate from high school?" rationale: When assessing a client's remote memory, the nurse should ask questions that determine the client's ability to remember things from the distant past. The nurse should ask questions that can be validated to ensure the information is correct.

A nurse is assessing a client who takes phenelzine for the treatment of depression. Which of the following findings is the priority for the nurse to report to the provider? A. Elevated blood pressure B. Weight gain C. Muscle twitching D. 2+ peripheral edema

A. Elevated blood pressure rationale: The greatest risk to this client is an elevated blood pressure, which increases the risk of a hypertensive crisis that can result from taking an MAOI like phenelzine.

A nurse in an acute care mental health facility observes a client who has bipolar disorder begin to shout and use offensive language toward a visitor. Which of the following actions should the nurse take? A. Give the client 2 options for ending the situation B. Move quickly to stand directly in front of the client before speaking C. Direct other clients to move toward the client as a show of force D. Tell the client that the conversation will be ended if the shouting continues

A. Give the client 2 options for ending the situation

A nurse is conducting a risk assessment for clients who are prescribed medications that can cause orthostatic hypotension. Which of the following medications requires a follow-up by the nurse? A. Phenelzine B. Escitalopram oxalate C. Galantamine D. Naltrexone

A. Phenelzine

A nurse on a rehabilitation unit is providing teaching to the partner of a client who is experiencing stimulant withdrawal. Which of the following statements by the partner indicates an understanding of the teaching? A. "Increased energy is a sign of withdrawal." B. "Depression is a manifestation of withdrawal." C. "Decreased appetite is a manifestation of withdrawal." D. "Delirium tremens can occur during withdrawal."

B. "Depression is a manifestation of withdrawal."

A nurse is providing teaching to a client who has ADHD and a new prescription for a transdermal methylphenidate patch. Which of the following statements by the client indicates an understanding of the teaching? A. "I will rotate placing the patch on different parts of my upper body." B. "I can take showers with the patch in place." C. "If the patch bothers my skin, I will switch to the oral form of the medication." D. "I will apply a patch each night at bedtime."

B. "I can take showers with the patch in place." A. The nurse should instruct the client that transdermal methylphenidate patches are to be applied to alternating hips daily. C. The nurse should instruct the client that a hypersensitivity reaction to the transdermal methylphenidate patch might prevent taking any form of methylphenidate, including oral doses. D. The nurse should instruct the client that transdermal methylphenidate patches are to be applied each morning and left in place for no more than 9 hours.

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." Benzodiazepines work immediately

A nurse is updating the plan of care for a client who has major depression and a new prescription for amitriptyline. The nurse should plan to monitor the client for which of the following adverse effects? A. Hypertension B. Drowsiness C. Panic attacks D. Diarrhea

B. Drowsiness

A nurse is planning care for a client who has completed detoxification from opioid abuse disorder. The nurse should plan to teach about which of the following medications? A. Methadone B. Naltrexone C. Buprenorphine D. Disulfiram

B. Naltrexone rationale: The nurse should plan to educate the client on the medication naltrexone, an opioid antagonist that is used for the long-term maintenance of opioid use disorder. Naltrexone is the usual medication choice following detoxification from opioids. A. Methadone is an opioid agonist that is prescribed as a substitute for opioids prior to detoxification. Clients must be approved by state and federal authorities to participate in methadone treatment. C. Buprenorphine is an opioid agonist-antagonist that is prescribed as a substitute for opioids prior to detoxification. D. Disulfiram is an aldehyde dehydrogenase medication that is prescribed as aversion therapy for alcohol use disorder. It is not prescribed for opioid use disorder.

A nurse is teaching a client who has depression and is scheduled for transcranial magnetic stimulation (TMS). The nurse should inform the client that TMS can cause which of the following adverse effects? A. Retrograde amnesia B. Seizures C. Confusion D. Suicidal ideation

B. Seizures

A charge nurse is discussing ethics with a newly licensed nurse. Which of the following actions should the charge nurse include as an example of beneficence? A. Taking a continuing education course about recognizing risk factors of suicide B. Spending extra time reorienting a client who is experiencing command hallucinations C. Acknowledging and accepting a client's refusal of a psychotropic medication D. Describing the purpose, action, and side effects of a psychotropic medication

B. Spending extra time reorienting a client who is experiencing command hallucinations rationale: The nurse should include this action as an example of beneficence, which is the duty to act to promote the good of others A. This action describes fidelity, which is maintaining loyalty and commitment to clients. Professional education falls under this ethical concept. C. This action describes autonomy, which is respecting the rights of clients to make their own decisions. Unless clients are deemed incompetent or present a danger to themselves or others, they retain the right to refuse treatment, including medications. D. This action describes veracity, which is the duty to communicate truthfully. Clients have the right to know about the risks and benefits of treatments, including the adverse effects and the expected outcomes of medications. The nurse should provide medication education in a way the client can understand and provide time for the client to ask questions.

A nurse is caring for a client with ADHD who has recently started taking lithium. For which of the following findings should the nurse monitor when evaluating the effectiveness of the medication? A. Increased attention span B. Decreased anxiety C. Reduced aggression D. Weight loss

C. Reduced aggression

A nurse is assessing a client who is taking buspirone to treat generalized anxiety disorder. Which of the following findings should the nurse identify as an adverse effect of this medication? A. Arthralgia B. Photophobia C. Xerostomia D. Bradycardia

C. Xerostomia

A nurse is interviewing a client who is seeking help for intimate partner violence. Which of the following client statements should the nurse identify as an indication that the client is in the tension-building phase of the cycle of violence? A. "Last night my partner beat me worse than ever before." B. "It'll be easier just to make my partner mad and get the violence over with." C. "I believe my partner is remorseful and won't hurt me again." D. "I only got shoved a little bit, and it was my fault for coming home late."

D. "I only got shoved a little bit, and it was my fault for coming home late." During this phase, episodes of violence are often minor, and the recipient might rationalize the episodes by accepting blame.

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. "I 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."

A nurse is providing teaching to a client who recently completed detoxification from alcohol and has a new prescription for acamprosate. Which of the following statements should the nurse make? A. "You will get very sick if you drink alcohol while taking this medication." B. "The medication will be administered as a subcutaneous injection." C. "You should take this medication on an empty stomach." D. "The medication might cause you to have episodes of diarrhea."

D. "The medication might cause you to have episodes of diarrhea."

A nurse is assessing a client who is taking lithium to treat bipolar disorder and has a lithium level of 2.2 mEq/L. Which of the following findings should the nurse expect? A. Muscle weakness B. Oliguria C. Vomiting D. Blurry vision

D. Blurry vision rationale: Manifestations of lithium toxicity with levels between 2 and 2.5 mEq/L include blurry vision, ataxia, clonic twitching, severe hypotension, and polyuria. A. Muscle weakness and fine hand tremors are early manifestations of lithium toxicity. These manifestations are common with lithium levels between 1.0 and 1.5 mEq/L. B. Manifestations of lithium toxicity with levels above 2.5 mEq/L include seizures and oliguria. For levels above 3.5 mg/dL, delirium, cardiovascular collapse, coma, and death can occur. C. Nausea, vomiting, diarrhea, and lethargy are early manifestations of lithium toxicity. These manifestations are common with lithium levels between 1.0 and 1.5 mEq/L.

A nurse is teaching a client who wants to stop smoking by using nicotine lozenges. Which of the following statements should the nurse make? A. "Drink water directly before taking the lozenge." B. "Place the lozenge under your tongue and let it dissolve." C. "Limit your use to no more than 20 lozenges per day." D. "Take 2 4-mg lozenges right after waking up in the morning."

The nurse should instruct the client that users should consume no more than 5 lozenges within 6 hours and should not have more than 20 lozenges per day