RN 220 Unit 1 review

Front

A nurse is providing teaching to the husband of a client with Alzheimer's disease, and has a new prescription for Donezepil. Which of the following statements by the husband means the teaching has been effective? This medication should decrease drooling for my wife. This medication should help my wife sleep better. This medication should help my wife's daily functioning. This medication should increase my wife's energy.

Back

This medication should help my wife's daily functioning.

Answer explanation

The nurse should recognize that donezepil slows the progression of AD and can improve behavior and daily functions. It does not decrease drooling, help with sleeping, or affect the appetite.

Front

After 1 week of continuous mental confusion, an older African American client is admitted with a preliminary diagnosis of Alzheimer's dementia. What should cause the nurse to question this diagnosis?

Back

Alzheimer's dementia does not develop suddenly.

Answer explanation

C is the correct choice because the onset of AD is longer term, whereas the client has had confusion for 1 week. African american and hispanic people are at more risk for AD. The symptoms do NOT describe parkinsonism.

Front

A nurse working in a long term care facility is planning care for a client who has moderate Alzheimer's. Which of the following interventions should be included in the plan of care?
Options:
Use a gait belt for ambulation.
Thicken all liquids.
Provide continuous monitoring of their actions.
Reorient the client to self and current events.

Back

Reorient the client to self and current events.

Answer explanation

In moderate AD, the client can still ambulate, eat regular food and would not require continuous monitoring. They WOULD require frequent reorientation to self and current events.

Front

A nurse in an outpatient mental health clinic is preparing to conduct an initial client interview. When conducting the interview, which action should the nurse identify as the priority? Options: Coordinate holistic care with social services, Include the family in the interview, Teach the client about their current mental health disorder.

Back

Identify the client's perception of their mental health status.

Front

A nurse is providing teaching for a client who is scheduled to receive ECT for the treatment of major depressive disorder. Which of the following client statements indicates understanding of the teaching? "It is common to treat depression with ECT before trying medications."; "I can have my depression cured if I receive a series of ECT treatments."; "I should receive ET once a week for 6 weeks."; "I will receive a muscle relaxant to protect me from injury during ECT."

Back

I will receive a muscle relaxant to protect me from injury during ECT.

Answer explanation

Electroconvulsive therapy (ECT) is considered in cases of treatment-resistant bipolar, depression, and schizophrenia. A client's condition may be considered treatment-resistant when medications have been tried and were found to be unsuccessful in relieving related symptoms. The client is given a general anesthetic to induce sleep and a muscle-paralyzing agent to prevent muscle distress and fractures. While an electrocardiograph (ECG) and electroencephalograph (EEG) monitor attached to the client, brief seizures are induced by an electrical current attached to one or both sides of the forehead. It is done 2-3 times a week for 4 weeks.

Front

A charge nurse is discussing Transmagnetic Stimulation (TMS) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? TMS is indicated for clients who have schizophrenia spectrum disorders. I will provide postanesthesia care following TMS. TMS treatments usually last 5-10 minutes. I will schedule the client for TMS treatments 3-5 times a week for the first several weeks.

Back

I will schedule the client for TMS treatments 3-5 times a week for the first several weeks.

Answer explanation

TMS is a procedure that utilizes magnetic pulses to stimulate focal areas of the cerebral cortex. Unlike ECT, no anesthesia is used. The outpatient procedures only last about 30 min, and the client usually comes for the treatment several times each week for six weeks. TMS, coupled with psychotherapy, has been shown to be very effective in the treatment of depression.

Front

A nurse observes a client who has OCD repeatedly applying, removing, and then reapplying makeup. The nurse identifies that repetitive behavior in a client who has OCD is due to which of the following underlying reasons?

Back

Attempt to reduce anxiety

Answer explanation

C. When analyzing data the nurse identifies that repetitive behavior in a client who has OCD repeats the behavior in an attempt to suppress persistent thoughts or urges that cause anxiety.

Front

A nurse is caring for a client who is starting Fluoxetine for treatment of panic disorder. Which of the following statements indicates the client understands the use of this medication? I will take the medication at bedtime. I will follow a low-sodium diet while taking this medication. I will need to discontinue this medication slowly. I will be at high risk for weight loss with long term use of this medication.

Back

I will need to discontinue this medication slowly.

Front

A nurse is asked by a client that has panic disorder, "What can I do to better control my panic attacks?" Which of the following statements by the nurse addresses modifiable risk factors? Options: "Physical activity can decrease the intensity and frequency of panic attacks.", "A family history of anxiety disorder will make controlling your panic attacks more difficult.", "Childhood trauma, abuse, and neglect can make you more vulnerable to panic disorders.", "Being separated from your birth parents at a young age explains why you have a panic disorder."

Back

Physical activity can decrease the intensity and frequency of panic attacks.