HESI - Elsevier Adaptive Quizzing #1

A client with a history of schizophrenia, who responds poorly to medication, is now being treated for acute depression. Which informaton would the nurse provide in light of the information elicited from the medication list and laboratory results? "Come in for weekly blood tests to monitor for medication-induced agranulocytosis." "Report incidents of unusual bleeding or easy bruising while taking fluoxetine." "Expect to be prescribed only 1 week's supply of fluoxetine at a time." "Consume a high-protein diet to offset the risk of anemia while taking clozapine."

"Come in for weekly blood tests to monitor for medication-induced agranulocytosis." The antipsychotic medication clozapine poses a risk for the development of agranulocytosis, especially when combined with a selective serotonin reuptake inhibitor such as fluoxetine. The client's neutrophil and white blood cell counts (WBCs) are borderline and therefore suggestive of the disorder. Weekly blood testing to monitor these blood values is required. The client's platelet count is in the low-normal range, but fluoxetine is not generally considered a factor in bleeding disorders. Clozapine, not fluoxetine, would likely be prescribed on a week-by-week basis to both help manage side effects and encourage weekly visits for lab work. Clozapine is not generally considered a factor in the development of anemia.

The nurse is caring for a 9-month-old infant with gluten-induced enteropathy. Which common term for this disorder would the nurse use when discussing the infant's diagnosis with the parents? Megacolon Celiac disease Cystic fibrosis Intussusception

Celiac disease Celiac disease, celiac sprue, and gluten-sensitive enteropathy are terms used interchangeably for the same pathophysiologic process. Aganglionic megacolon, also referred to as Hirschsprung disease, is characterized by chronic constipation; it is not a gluten-induced enteropathy. Although similar to celiac disease in many of its clinical manifestations, cystic fibrosis is an inherited disorder characterized by increased viscosity of mucous gland secretions throughout the body, not a gluten-induced enteropathy. Intussusception is an intestinal anomaly that causes invagination or telescoping of one portion of the intestine into another; it is an acute problem rather than a chronic disorder and is not a gluten-induced enteropathy.

Which guideline would the nurse consider when planning care for a hospitalized older client with Alzheimer disease? Physical contact will increase dependency needs. Routines provide stability for clients with neurocognitive disorders. Regressive behavior should be interrupted immediately. Procedures do not have to be explained to clients with neurocognitive disorders.

Routines provide stability for clients with neurocognitive disorders. Routines provide stability for clients with neurocognitive disorders. Rituals and routines in activities of daily living provide a framework and structure for clients with Alzheimer disease, adding to their sense of safety and security. Touch is a universal message that denotes caring; it can be soothing and will not encourage dependency, and touch may have to be used judiciously depending upon the stage of Alzheimer disease. Regressive behavior under stress has a calming effect and should be allowed. Care should be explained to all clients; simple declarative statements are usually understood by clients with Alzheimer disease.

Atenolol 150 mg by mouth is prescribed for a client with hypertension. Each tablet contains 50 mg. How many tablets will the nurse administer?

3 tablets

Which antidepressant medication is a selective monoamine oxidase-B inhibitor? Selegiline Phenelzine Isocarboxazid Tranylcypromine

Selegiline Selegiline is a selective monoamine oxidase-B inhibitor. Phenelzine, isocarboxazid, and tranylcypromine are nonselective monoamine oxidase-A and monoamine oxidase-B inhibitors.

A client has a prescription for 125 mg of phenytoin by mouth three times a day. Phenytoin is supplied as an oral suspension of 25 mg/5 mL. How many milliliters of solution will the nurse administer for each dose?

25 mL

Phenytoin suspension 200 mg is prescribed for a client with epilepsy. The suspension contains 125 mg/5 mL. How many milliliters will the nurse administer?

8 mL

A client is to receive 0.22 g of zinc sulfate by mouth. Each tablet contains 110 mg. How many tablets will the nurse administer?

2 tablets

Which assessment finding indicates an improvement when the nurse is evaluating the results of treatment with erythropoietin? 2+ pedal pulses Decreased pallor Decreased jaundice 2+ deep tendon reflexes

Decreased pallor Erythropoietin stimulates red blood cell production, thereby decreasing the pallor that accompanies anemia. It would not have an appreciable effect on pulses or deep tendon reflexes. It would not have a role in alleviating jaundice.

A client is prescribed 4 mg of hydromorphone intravenously (IV) every 4 hours, as needed. Hydromorphone is supplied at 10 mg/mL. How many milliliters of hydromorphone will the nurse administer per dose?

0.4 mL

Which volume of solution would be prepared when the nurse receives an order to prepare a solution for administering a cleansing enema for an adolescent client? 150 to 250 mL 250 to 350 mL 300 to 500 mL 500 to 750 mL

500 to 750 mL In adolescents, the volume of solution required is 500 to 750 mL. The nurse would prepare 150 to 250 mL of warmed solution for infants. The nurse would prepare 250 to 350 mL of warmed solution for administering a cleansing enema in a toddler. In school-age children, the volume of warmed solution is 300 to 500 mL.

Which explanation would the nurse provide for administering prednisone to a client with an exacerbation of colitis? The client will be protected from getting an infection. Symptoms associated with the colitis will decrease slowly over time. Although the medication causes anorexia, weight loss may not occur. Although the medication decreases intestinal inflammation, it will not cure the colitis.

Although the medication decreases intestinal inflammation, it will not cure the colitis. Prednisone inhibits phagocytosis and suppresses other clinical phenomena of inflammation; this is a symptomatic treatment that is not curative. The medication suppresses the immune response and increases the potential for infection. The response usually is rapid. Appetite is increased; weight gain may result from this or from fluid retention.

Which property would the nurse understands that the medication is being used primarily for when aspirin is prescribed on a regular schedule for a client with rheumatoid arthritis? Analgesic Antipyretic Anti-inflammatory Antiplatelet

Anti-inflammatory The anti-inflammatory action of aspirin reduces joint inflammation. It can relieve pain and prevent abnormal clotting; however, although these effects can be beneficial, these are not the primary reasons that it is prescribed for rheumatoid arthritis. Aspirin reduces fever, but this is not the rationale for prescribing it for clients with rheumatoid arthritis.

Which action will the nurse take after stopping the antibiotic infusion of a client who becomes restless and flushed, and begins to wheeze during the administration of an antibiotic? Check the client's temperature. Take the client's blood pressure. Obtain the client's pulse oximetry. Assess the client's respiratory status.

Assess the client's respiratory status. The client is experiencing an allergic reaction that may progress to anaphylaxis. Anaphylactic shock can lead to respiratory distress as a result of laryngeal edema or severe bronchospasm. Assessing and maintaining the client's airway is the priority. Checking the client's temperature and taking the client's blood pressure are not the priority; vital signs should be obtained after airway patency is ensured and maintained. Pulse oximetry is only one portion of the needed respiratory status assessment.

Which response would the nurse give when an adolescent who has had a leg amputated because of bone cancer begins to experience phantom limb sensations? By withholding the medication to help prevent addiction By stating that the limb has been removed and that the pain is psychological By acknowledging that the pain is real and administering medication to relieve it By explaining that the phantom limb sensation will subside within a few more days

By acknowledging that the pain is real and administering medication to relieve it Pain medication is required, along with intensive supportive nursing care. To the client the pain is real, requiring pain medication; addiction is not a concern at this time. Explaining that the pain is psychological in origin does not help relieve the pain; medication and emotional support are required. The pain may not recede within a few days; pain medication should be administered.

Which toxic effect would the nurse find in a client who has overdosed on isocarboxazid? Mydriasis Bradycardia Hypothermia Circulatory collapse

Circulatory collapse The clinical symptoms of monoamine oxidase inhibitors (MAOIs) generally appear after 12 hours of ingestion. Circulatory collapse is associated with MAOI toxicity. Mydriasis, bradycardia, and hyperthermia are not associated with an isocarboxazid overdose.

Which action is the function of antidiuretic hormone (ADH)? Reduces blood volume Decreases water loss in urine Increases urine output Initiates the thirst mechanism

Decreases water loss in urine ADH is released by the posterior pituitary gland. It is released mainly in response to either a decrease in blood volume or an increased concentration of sodium or other substances in the plasma. ADH acts to decrease the production of urine by increasing the reabsorption of water by renal tubules. A decrease in ADH would cause reduced blood fluid volume; decreased ability of the kidneys to reabsorb water, resulting in increased urine output; and an increase in the thirst mechanism.

Which condition is contraindicated for St. John's wort herbal therapy? Anxiety Seizures Dementia Cardiac disease

Dementia St. John's wort is contraindicated for dementia; this herbal therapy is used to treat anxiety. Bupropion therapy is contraindicated for seizures. Valerian (Valeriana officinalis) is contraindicated for cardiac disease.

When evaluating fluid loss for a client with burns, which relationship between a client's burned body surface area and fluid loss would the nurse consider ? Equal Unrelated Inversely related Directly proportional

Directly proportional There is greater extravasation of fluid into the tissues as the amount of tissue involved increases. Thus the relationship of fluid loss to body surface area is directly proportional. Formulas (e.g., Parkland [Baxter]) are used to estimate fluid loss based on percentage of body surface area burned. Equal, unrelated, and inversely related options are incorrect; the relationship is proportional.

Which age-related effects on the immune system occur in the older client? Increased autoantibodies Increased expression of IL-2 receptors Increased delayed hypersensitivity reaction Increased primary and secondary antibody responses

Increased autoantibodies Rationale The effects of aging on the immune system include increased autoantibodies. Expression of IL-2 receptors, delayed hypersensitivity reaction, and primary and secondary antibody responses decrease in older adults because of the effects of aging on the immune system.

Which medication may lead to bruxism? Vilazodone Isocarboxazid Clomipramine Levomilnacipran

Levomilnacipran Serotonin reuptake inhibitors and serotonin/norepinephrine reuptake inhibitors may lead to bruxism. Levomilnacipran is a serotonin/norepinephrine reuptake inhibitor that may cause bruxism. Vilazodone is an atypical antidepressant that does not cause bruxism. Isocarboxazid is a monoamine oxidase inhibitor that does not cause bruxism. Clomipramine is a tricyclic antidepressant that does not cause bruxism.

Why is a multiple-gestation pregnancy considered a high risk? Postpartum hemorrhage is an expected complication. Perinatal mortality is two to three times more likely in multiple than in single births. Optimal psychological adjustment after a multiple birth requires 6 months to 1 year. Maternal mortality is higher during the prenatal period in the setting of multiple gestation.

Perinatal mortality is two to three times more likely in multiple than in single births. Perinatal morbidity and mortality rates are higher with multiple-gestation pregnancies, because the greater metabolic demands and the possibility of malpositioning of one or more fetuses increase the risk for complications. Although postpartum hemorrhage does occur more frequently after multiple births, it is not an expected occurrence. Adjustment to a multiple gestation and birth is individual; the time needed for adjustment does not place the pregnancy at high risk. Maternal mortality during the prenatal period is not increased in the presence of a multiple gestation.

Which condition contraindicates the use of ginseng herbal therapy? Pregnancy Schizophrenia Bipolar depression Alzheimer disease

Pregnancy Pregnancy is contraindicated for ginseng herbal therapy. Schizophrenia, bipolar depression, and Alzheimer disease are contraindicated for St. John's Wort herbal therapy.

A client with chronic obstructive pulmonary disease (COPD) has a blood pH of 7.25 and a partial pressure of carbon dioxide (PCO 2) of 60 mm Hg. Which complication would the nurse suspect the client is experiencing? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Respiratory acidosis The pH indicates acidosis; the PCO 2 level is the parameter for respiratory function. The expected PCO 2 is 40 mm Hg. These results do not indicate a metabolic disorder or indicate respiratory alkalosis.

Which rationale supports the nursing intervention to turn the client with paraplegia every 1 to 2 hours? To maintain client comfort To prevent development of pressure injuries To prevent flexion contractures of the extremities To improve venous circulation in the lower extremities

To prevent development of pressure injuries Pressure injuries easily develop when maintaining a particular position; the body weight, directed continuously in one region, restricts circulation and results in tissue necrosis. Denervated tissue has less perfusion and is more prone to pressure injuries. Clients often state they are comfortable and wish to remain in one position. More effective measures to prevent contractures include proper positioning with supportive devices and range of motion. Because turning usually occurs laterally, the circulation to the lower extremities is not dramatically affected.

Which intervention would the nurse recommend if a teenager being discharged with a cast experiences pruritus around the cast edges? "Scratch the itchy area gently." "Put an ice pack on the affected area." "Sprinkle a layer of powder around the itchy spots." "Ask your doctor for a prescription for an antihistamine."

"Put an ice pack on the affected area." An ice pack numbs the area and may temporarily diminish the discomfort. Scratching stimulates the release of histamine, which worsens the pruritus; also, scratching may break the skin and open an avenue for infection. Powder may become caked and slip under the cast, causing additional discomfort. Also, powder should be avoided because it is toxic if inhaled. Antihistamines are not prescribed unless all other measures have failed.

Which procedure is shown in the picture? A thoracentesis A mediastinoscopy A transbronchial biopsy Computed tomography

A thoracentesis A thoracentesis involves inserting a catheter into the pleural space to obtain specimens of pleural fluid or to remove a pleural effusion. A mediastinoscopy involves a scope inserted through a small incision in the suprasternal notch advanced into the mediastinum to inspect and biopsy lymph nodes. A transbronchial biopsy involves passing forceps through a bronchoscope to obtain a biopsy specimen. Computed tomography is a radiologic test used to diagnose lesions that are difficult to assess via conventional x-ray studies.

Which statements regarding acne are correct? Select all that apply. One, some, or all responses may be correct. Acne is a hormonal disease. Acne may be caused by stress. Family history could be a reason for acne. Propionibacterium acnes causes acne. Acne is commonly found on the face, chest, upper back, and neck.

Acne may be caused by stress. Family history could be a reason for acne. Propionibacterium acnes causes acne. Stress and family history may cause acne formation. The causative organism is Propionibacterium acnes. Acne is commonly found on the face, chest, upper back, and neck where there are a higher number of sebaceous glands. Acne is not a hormonal disease; rather, it is a skin disease due to hormonal imbalance.

Which required noninvasive assessment and management skills certification would the nurse need to perform airway maintenance and cardiopulmonary resuscitation (CPR)? Basic Life Support (BLS) Certified Emergency Nurse (CEN) Advanced Cardiac Life Support (ACLS) Pediatric Advanced Life Support (PALS)

Basic Life Support (BLS) BLS is the certification for emergency nursing that includes assessment and management skills for airway maintenance and CPR. CEN is emergency nursing certification that validates the core emergency nursing knowledge base. ACLS involves invasive airway management skills, pharmacology, electrical therapies, and special resuscitation. PALS involves neonatal and pediatric resuscitation.

The nurse applies a cold pack to relieve musculoskeletal pain. Which rationale explains the analgesic properties of cold therapy? Promotes analgesia and circulation Numbs the nerves and dilates the blood vessels Promotes circulation and reduces muscle spasms Causes local vasoconstriction, preventing edema and muscle spasms

Causes local vasoconstriction, preventing edema and muscle spasms Cold causes the blood vessels to constrict, which reduces the leakage of fluid into the tissues and prevents swelling and muscle spasms. Cold does promote analgesia but not circulation. It may numb nerves but does not dilate blood vessels. Cold therapy also may numb the nerves and surrounding tissues, thus reducing pain.

Which statement is true regarding antipsychotic medications? All first- and second-generation antipsychotics are equally effective. Second-generation antipsychotics pose a risk of extrapyramidal symptoms. First-generation antipsychotics pose a significant risk of metabolic side effects. Clozapine is more effective than other second-generation antipsychotics.

Clozapine is more effective than other second-generation antipsychotics. Clozapine is a second-generation antipsychotic medication that is more effective than other second-generation antipsychotics. Most (but not all) first- and second-generation antipsychotics are equally effective. Second-generation antipsychotics may cause metabolic side effects such as diabetes and dyslipidemia. First-generation antipsychotics may cause extrapyramidal side effects.

Which finding in older adult clients is associated with aging? Decrease in height Decreased neck rigidity Increased fine-motor dexterity Increased range of motion (ROM)

Decrease in height Loss of height and deformity and shortening of the trunk are common in older adults because of vertebral compression and degeneration. Rigidity in the neck, shoulders, back, hips, and knees increases with age because of loss of elasticity in ligaments, tendons, and cartilage. A decline in fine-motor dexterity occurs in the older adult because of slow impulse conduction along motor units. Range of motion (ROM) is limited in the older adult because of cartilage erosion, increased friction between the bones, and overgrowth of bone around joint margins.

Which mechanism of action would the nurse identify for levodopa therapy prescribed to a client diagnosed with Parkinson disease? Blocks the effects of acetylcholine Increases the production of dopamine Restores the dopamine levels in the brain Promotes the production of acetylcholine

Restores the dopamine levels in the brain Levodopa is a precursor of dopamine, a catecholamine neurotransmitter; it increases dopamine levels in the brain that are depleted in Parkinson disease. Blocking the effects of acetylcholine is accomplished by anticholinergic medications. Increasing the production of dopamine is ineffective because it is believed that the cells that produce dopamine have degenerated in Parkinson disease. Levodopa does not affect acetylcholine production.

Which organism would the nurse explain was responsible for a client's recent diagnosis of malaria? Vibrio Sporozoa Ringworm Spirochetes

Sporozoa Sporozoa such as Plasmodium malariae cause malaria. Vibrio are curved rod-shaped bacteria; these microorganisms cause cholera. Ringworm such as tinea corporis may cause mycotic infections. Spirochetes are spiral-shaped bacteria; these microorganisms may cause leprosy and syphilis.

Which action would the nurse take when a confused and anxious client voids on the floor in the sitting room of the mental health unit? Make the client mop the floor. Restrict the client's fluids for the rest of the day. Toilet the client more frequently with supervision. Withhold the client's privileges each time the client voids on the floor.

Toilet the client more frequently with supervision. The nurse would toilet the client more frequently with supervision. The client is voiding on the floor not to express hostility but because of confusion. Taking the client to the toilet frequently reduces the risk of voiding in inappropriate places. Making the client mop the floor is a form of punishment for something the client cannot control. Restricting the client's fluids for the rest of the day is not realistic; it will have no effect on the problem and may lead to physiological problems. If the client were doing this to express hostility, withholding privileges might be effective, but not when the client is unable to control the behavior.

Which intervention would the nurse recommend for post-cesarean gas pain? Lying on the right side Walking around the room Using a straw when drinking water Supporting the incision when moving

Walking around the room Walking around as much as possible can help expel excess gas after a cesarean birth. The client also may be advised to lie on the left (not right) side and rock in a rocking chair. The client should avoid using a straw when drinking water or other fluids. Supporting the incision when moving relieves incisional pain, but does not promote expulsion of gas.

The home health nurse provides education for a client with cancer of the tongue who will begin gastrostomy feedings at home. Which client statement indicates effective teaching? "Before I start the procedure, I will don sterile gloves." "Before I start the procedure, I will obtain my body weight." "Before I start the procedure, I will measure the residual volume." "Before I start the procedure, I will instill 1 oz [30 mL] of a carbonated liquid."

"Before I start the procedure, I will measure the residual volume." Measuring the residual volume establishes the absorption amount of the previous feeding. If a residual exceeds the parameter identified by the health care provider or is over 200 mL, a feeding may be held. This safety measure prevents adding excess feeding solution that may lead to abdominal distention, nausea, vomiting, and aspiration. Clean, not sterile, gloves are necessary to protect the client from contamination with gastric secretions. The client obtains and reports weekly or monthly weights, depending on the client's condition and clinical goals. If the tube becomes clogged, the client may instill 30 mL of a carbonated beverage; this action is not used routinely.

A client who has been taking the prescribed dose of zolpidem for 5 days returns to the clinic for a follow-up visit. Which statement by the client indicates the medication has been effective? "I have less pain." "I have been sleeping better." "My blood glucose is under control." "My blood pressure is coming down."

"I have been sleeping better." Zolpidem is a sedative-hypnotic that produces central nervous system depression in the limbic, thalamic, and hypothalamic areas of the brain. Zolpidem is not an analgesic, antidiabetic, or antihypertensive medication.

The nurse explains to the parents of a 6-year-old child with a pinworm infestation how pinworms are transmitted. Which statement indicates that the teaching has been understood? "We need to keep the cat off the bed." "She needs to wash her hands before eating anything." "She needs to cover her mouth whenever she coughs." "We need to tell the school so that the cafeteria can be cleaned."

"She needs to wash her hands before eating anything." Pinworm infestation is transferred by way of the oral-anal route, and effective hand washing is the best way to prevent transmission. Cats do not transmit pinworms. The hands should be kept away from the nose and mouth; the child should be taught to cough into a tissue or the inside elbow of the arm. Pinworms are not transmitted by coughing. Cleaning the cafeteria is not an effective means of preventing the transmission of pinworms.

Planning to provide self-care health information for several clients, which client would the nurse anticipate will be most motivated to learn? A 55-year-old client who had a mastectomy and is very anxious about her body image An 18-year-old client who smokes cigarettes and is in denial about the dangers of smoking A 56-year-old client who had a heart attack last week and is requesting information about exercise A 47-year-old client who has a long-leg cast after sustaining a broken leg and is still experiencing severe pain

A 56-year-old client who had a heart attack last week and is requesting information about exercise A client who is requesting information is indicating a readiness to learn. When the nurse is caring for a person who is coping with the diagnosis of cancer and a change in body image, the nurse would encourage the expression of feelings, not engage in teaching. People in denial are not ready to learn because they do not admit they have a problem. In addition, many adolescents believe that they are invincible. A person who is in pain is attempting to cope with a physiological need. This client is not a candidate for teaching until the pain can be lessened; pain can preoccupy the client and prevent focusing on the information being presented.

When developing the plan of care for a client with rheumatoid arthritis, which client consideration would the nurse include? Surgery Comfort Education Motivation

Comfort Because pain is an all-encompassing and often demoralizing experience, the nurse would want to keep the client as pain-free as possible. Surgery corrects deformities and facilitates movement, which is not an immediate need. Concentration and motivation are difficult when a client is in severe pain.

A client with schizophrenia who is receiving an antipsychotic medication begins to exhibit a shuffling gait and tremors. The primary health care provider prescribes the anticholinergic medication benztropine, 2 mg daily. Which symptom should the nurse should inquire about when assessing the client? Constipation Hypertension Increased salivation Excessive perspiration

Constipation The anticholinergic activity of each medication is magnified, and adverse effects such as paralytic ileus may occur. Hypotension, not hypertension, occurs with anticholinergic medications. Dryness of the mouth, not increased salivation, occurs with anticholinergic medications. Decreased, not increased, perspiration occurs with anticholinergic medications.

Which autoantigens are responsible for the development of Crohn disease? Crypt epithelial cells Thyroid cell surface Basement membranes of the lungs Basement membranes of the glomeruli

Crypt epithelial cells Crypt epithelial cells are considered the autoantigens responsible for Crohn disease. Thyroid cell surfaces are autoantigens responsible for Hashimoto thyroiditis. The pulmonary and glomerular basement membranes act as autoantigens responsible for Goodpasture syndrome.

Which action would the nurse take to help a female client diagnosed with bipolar disorder in the manic episode meet personal hygiene needs? Suggest that she wear hospital clothing. Guide her to dress appropriately in her own clothing. Allow her to apply makeup in whatever manner she chooses. Keep makeup away from her because she will apply it too freely.

Guide her to dress appropriately in her own clothing. The nurse would guide the client to dress appropriately in her own clothing. Having clients who are experiencing a manic episode of bipolar disorder wear personal clothing helps keep them more in touch with reality. The client may need direction to dress appropriately. Suggesting that she wear hospital clothing does not help the client learn to follow the therapeutic milieu. Allowing her to apply makeup in whatever manner she chooses may set up the client as a target of ridicule by other clients. The client may use makeup but with supervision.

A client is receiving haloperidol for agitation, and the nurse is monitoring the client for side effects. Which response identified by the nurse is unrelated to an extrapyramidal tract effect? Akathisia Opisthotonos Oculogyric crisis Hypertensive crisis

Hypertensive crisis A hypertensive crisis is not associated with extrapyramidal tract symtoms. Akathisia, characterized by restlessness and twitching or crawling sensations in the muscles, is an extrapyramidal side effect. Opisthotonos, characterized by hyperextension and arching of the back, is an extrapyramidal side effect. Oculogyric crisis, characterized by the uncontrolled upward movement of the eyes, is an extrapyramidal side effect.

Which medication is the first choice of medication for the treatment of attention-deficit/hyperactivity disorder (ADHD)? Clonidine Guanfacine Atomoxetine Methylphenidate

Methylphenidate Methylphenidate is the first choice of medication for the treatment of attention-deficit/hyperactivity disorder (ADHD). Clonidine, guanfacine, and atomoxetine are nonstimulants used to treat ADHD; these medications are less effective than methylphenidate.

Which medication is indicated to treat shift-work sleep disorder (SWSD)? Caffeine Modafinil Atomoxetine Methylphenidate

Modafinil Modafinil is a unique nonamphetamine stimulant used to treat SWSD. This medication promotes wakefulness in clients suffering from excessive sleepiness associated with SWSD. Caffeine is a central nervous stimulant used to promote wakefulness, but this medication is not as effective in the treatment of SWSD. Atomoxetine is a nonstimulant used to treat attention-deficit/hyperactivity disorder (ADHD). Methylphenidate is considered a first-choice medication for the treatment of ADHD.

Which area of the client's body would the nurse consider a high risk for developing a pressure injury when caring for an older adult with Alzheimer type dementia who consistently sleeps in a semi-Fowler position in bed? Sacrum Scapulae Ischial spine Greater trochanter

Sacrum The sacrum is the center of the greatest body mass; an elevated torso exerts pressure toward this area. Although the scapulae are at risk, they do not bear the greatest body weight as when the client is in the semi-Fowler position. The ischial spine bears the greatest pressure when the client is in an upright sitting position. Greater trochanter is at risk when the client is in a side-lying position.

Which action is accurate in explaining how neuroleptic medications act in the body to promote mental health for clients diagnosed with schizophrenia? They inhibit enzymes at the postsynaptic receptor site. They decrease serotonin at the postsynaptic receptor site. They increase dopamine uptake at the postsynaptic receptor site. They block access to dopamine receptors at the postsynaptic receptor site.

They block access to dopamine receptors at the postsynaptic receptor site. Neuroleptics block access to dopamine receptors, rather than inhibiting enzymes, at postsynaptic sites. They increase, not decrease, serotonin at postsynaptic sites.

An adult client with low-functioning Down syndrome (trisomy 21) appears in the emergency department via ambulance after an accident. Which assessment method would be the best instrument to use when determining this client's level of pain? Asking the client's parent Using the Wong-Baker FACES Pain Rating Scale Observing the client's body language Explaining and using the 0 to 10 pain scale

Using the Wong-Baker FACES Pain Rating Scale An adult client with limited mental capacity may not understand the concept of numbers as an indicator of levels of pain; the Wong-Baker FACES Pain Rating Scale uses pictures to which the individual can relate. The client, irrespective of mental capacity, is the primary source from whom to obtain information about pain because it is a personal experience. Body language provides some information, but it may not accurately reflect the client's level of pain. A client with limitations in mental functioning may not understand the concept of numbers.