BEHAVIOR EAQ

An alcohol-intoxicated client is found near drowning. What is the emergency care provided to the client by the nurse in the order of priority? A. Perform cariopulmonary resuscitation. B. Stabilize the spine with a board. C. Safely rescue the client. D. Perform gastric decompression with a nasogastric tube.

1) C. Safely rescue the client 2) B. Stabilize the spine with a board 3) A. Perform cardiopulmonary resuscitation 4) D. Perform gastric decompression with a nasogastric tube

A client with a history of aggressive, violent behavior is admitted to the psychiatric unit involuntarily. The nurse, who understands the need to use deescalation approaches during the preassaultive stage of the violence cycle, monitors the client's behavior closely for progression of signs of impending violence. List these client assessments in order of escalating aggression, from the lowest risk to the highest. A. Engaging in verbal abuse toward the nurse B. Having difficulty waiting to take turns during a group project C. Pushing another client while waiting in line to the dining room D. Increasing tension in facial expression E. Pacing in the hall

1) D. Increasing tension in facial expression 2) B. Having difficulty waiting to take turns during a group project 3) E. Pacing in the hall 4) A. Engaging in verbal abuse toward the nurse 5) C. Pushing another client while waiting in line to the dining room

A pregnant woman continues consuming alcohol during pregnancy. Which teratogenic effects might be seen in the fetus or neonate? Select all that apply. A. Stillbirth B. Ebstein anomaly C. Neural tube defects D. Spontaneous abortion E. Intellectual disabilities

A, D, E

A client who is addicted to opioids undergoes emergency surgery. During the postoperative period the healthcare provider decreases the previously prescribed methadone dosage. For what clinical manifestations will the nurse monitor the client? A. Constipation and lack of interest in surroundings B. Agitation and attempts to escape from the hospital C. Skin dryness and scratching under the incision dressing D. Lethargy and refusal to participate in therapeutic exercises

B

A client is admitted to the drug detoxification unit for cocaine withdrawal. What is the nurse's primary concern while working with clients withdrawing from cocaine? A. Risk for self-injury B. Potential for seizure C. Danger of dehydration D. Probability of injuring others

A

A client undergoing alcohol detoxification asks about attending Alcoholics Anonymous (AA) meetings after discharge. What is the nurse's best initial reply? A. "You'll find that you'll need their support." B. "How do you feel about going to those meetings?" C. "They'll help you to learn how to cope with your problem." D. "Don't you think it's better to wait until you're sure that you're ready?"

B

A primary healthcare provider writes a prescription of "Restraints PRN" for a client who has a history of violent behavior. What is the nurse's responsibility in regard to this prescription? A. Asking that the prescription indicate the type of restraint B. Recognizing that PRN prescriptions for restraints are unacceptable C. Implementing the restraint prescription when the client begins to act out D. Ensuring that the entire staff is aware of the prescription for the restraints

B

A young adult being treated for substance abuse asks the nurse about methadone. The nurse responds that methadone is useful in the treatment of opioid addiction because it has what characteristic? A. Is a nonaddictive drug B. Has an effect of longer duration C. Does not produce a cumulative effect D. Carries little risk of psychological dependence

B

What behavioral findings correspond to intimate partner violence in young adolescents? Select all that apply. A. Sexually acting out B. Attempting suicide C. Pattern of substance abuse D. Fear of certain people or places E. Preoccupation with others or one's own genitals

B, C

A client with a history of methamphetamine use is admitted to the medical unit. What clinical manifestation does the nurse expect when assessing the client? A. Constriced pupils B. Intractable diarrhea C. Increased heart rate D. Decreased respirations

C

A nurse is caring for a client who has been hospitalized for alcohol withdrawal. The client decides to attend an Alcoholics Anonymous (AA) meeting. What is a basic principle of this group? A. Spouses should attend Al-Anon meetings. B. A commitment to permanent abstinence must be made. C. Amends must be made to each person who has been harmed. D. People have the power to overcome alcoholism if they truly want to stop drinking.

C

A client with a history of violence is increasingly agitated. Which immediate nursing intervention will most likely increase the risk of acting-out behavior? A. Being assertive B. Responding early C. Providing choices D. Teaching relaxation

D

What is the most appropriate time for the nurse to administer an intravenous opioid analgesic to a client in active labor? A. Between contractions B. When a contraction starts C. At the peak of a contraction D. Just before the end of a contraction

B

A nurse is counseling a client who abuses cocaine. The nurse recognizes that this drug is representative of which drug category? A. An opioid B. A stimulant C. A barbiturate D. A hallucinogen

B

The nurse is reviewing the Alcohol Use Disorders Identification Test (AUDIT) reports of four clients. Which client requires highest priority for treatment? A. A B. B C. C D. D

D

A 23-year-old client is admitted to a psychiatric unit after several episodes of uncontrolled rage at her parents' home, and borderline personality disorder is diagnosed. While watching a television newscast describing an incident of violence in the home, the client says, "People like that need to be put away before they kill someone." The nurse concludes that the client is using what? A. Denial B. Projection C. Introjection D. Sublimation

B

A client going through an emotional disturbance often gets violent and tries to commit suicide. Which care system is best for the client? A. Rehabilitation B. Psychiatric facility C. Intensive care unit D. Extended-care facility

B

A client is admitted to the hospital for acute gastritis and ascites secondary to alcoholism and cirrhosis. For which condition is it most important for the nurse to assess this client? A. Nausea B. Blood in the stool C. Food intolerances D. Hourly urinary output

B

A client is brought by ambulance to the emergency department. The client's signs and symptoms are indicative of opioid overdose. What does the nurse expect the primary healthcare provider to prescribe? A. Naloxone B. Methadone C. Epinephrine D. Amphetamine

A

Client 1: History of being physically and sexually abused by family member from ages 4 to 12 years; exhibits stress through hyperactivity Client 2: History of violent behavior when under the influence of alcohol; has been abusing alcohol for 10 years Client 3: Currently oriented but displays impaired memory; frequently unable to recognize familiar caregivers Client 4: Currently paranoid; suspicious of "FBI agents." Assessment data are collected on four different clients being assessed for safety risks to themselves and others. Which client does the nurse identify as being at the greatest risk for violent behavior? A. Client 1 B. Client 2 C. Client 3 D. Client 4

A

A client has been in the alcohol detoxification unit for 5 days. In the evening the client complains of numbness and tingling in the feet and legs. What is the most appropriate nursing intervention? A. Massaging the client's legs with lotion B. Emphasizing the need to rest and keep the legs elevated C. Keeping the bed linens of the client's legs with a mechanical aid D. Monitoring the progression of symptoms and assessing the pedal pulses frequently

C

A client with a history of alcoholism is found to have Wernicke encephalopathy associated with Korsakoff syndrome. What does the nurse anticipate will be prescribed? A. Traditional phenothiazine B. Judicious use of antipsychotics C. Intramuscular injections of thiamine D. Oral administration of chlorpromazine

C

A client with a history of excessive alcohol use develops hepatic portal hypertension and an elevated serum aldosterone level. For which complications should the nurse assess this client? A. Chloride depletion and hypovolemia B. Potassium retention and dysrhythmias C. Sodium retention and fluid accumulation D. Calcium depletion and pathologic fractures

C

A nurse is caring for a client with the diagnosis of alcohol withdrawal delirium. Which action is most appropriate for the nurse to implement? A. Keeping the client calm by applying wrist restraints. B. Encouraging the client to relate the content of hallucinations C. Assuring the client that the symptoms are part of the withdrawal syndrome D. Dimming the client's room lights to counter the visual distortions being experienced

C

Which physical skin finding indicates opioid abuse? A. Diaphoresis B. Red, dry skin C. Needle marks D. Spider angiomas

C

A healthcare provider prescribes disulfiram for a client who abuses alcohol. The nurse teaches the client that disulfiram will have which action? A. Affect short-term memory B. Permit a healthier lifestyle C. Allow the client to tolerate small amounts of alcohol D. Cause a severe adverse reaction if alcohol is consumed

D

A client who has a diagnosis of paranoid schizophrenia and has been violent in the past is admitted to the psychiatric unit. What should the nurse do before conducting an admission interview? A. Move to the client's side and sit down B. Alert the assault response team about the client's history. C. Have two other staff members present when talking with the client. D. Enter the room with another staff member while remaining between the client and the door.

D

A client with a history of a short temper and physically abusive behavior becomes violent and is admitted to the psychiatric service. At the time of admission the client is extremely anxious. What is the priority nursing action? A. Sitting quietly with the client B. Encouraging the client to play video games C. Introducing the client to several other clients D. Assigning a staff member to supervise the client

D

A cocaine addict remanded for rehabilitation by the court is angry at being hospitalized. When his wife comes to visit, he is furious and curses at her. He refuses to visit with her and tells her to go home. The wife leaves in tears. What should the nurse say to the client? A. "You're very angry right now." B. "Let's talk about what just happened." C. "Let's go to your next scheduled activity." D. "You should go to the gym to use the punching bag."

B

A person who is hospitalized for alcoholism becomes boisterous, belligerent and verbally threatens the nurse. What is the most appropriate response by the nurse? A. Placing the client in restraints B. Sedating and placing the client in a controlled environment C. Encouraging the client to play table tennis with another client D. Setting firm limits on the client's behavior and enforcing adherence to them

B