Showing posts with label Psychiatric Mental Health. Show all posts

Nurse Mary is assigned to care for a suicidal client. Initially, which is the nurse’s highest care priority.. Exploring the nurse’s own feelings about suicide

Nurse Mary is assigned to care for a suicidal client. Initially, which is the nurse’s highest care priority?

A. Assessing the client’s home environment and relationships outside the hospital
B. Exploring the nurse’s own feelings about suicide
C. Discussing the future with the client
D. Referring the client to a clergyperson to discuss the moral implications of suicide

The nurse's highest care priority in this scenario is B. Exploring the nurse's own feelings about suicide.

Here's why:

Self-awareness is crucial: Nurses caring for suicidal clients need to be aware of their own feelings and biases about suicide. This helps them provide empathetic and effective care without projecting their own emotions onto the client.
Avoidance of countertransference: If a nurse is struggling with their own feelings about suicide, it can lead to countertransference, where they project their own emotions and experiences onto the client. This can hinder the therapeutic relationship and potentially harm the client.
Effective therapeutic relationship: A nurse who is self-aware and can manage their own emotions can establish a strong therapeutic relationship with the client. This is essential for providing support and guidance.

While the other options are important, they are not the highest priority at this initial stage. Assessing the home environment and relationships can be done later in the care process. Discussing the future with the client is important but should be approached with sensitivity and in collaboration with the client's therapist or psychiatrist. Referring the client to a clergyperson is a personal choice and may not be appropriate for all clients.

the Nurse's Highest Priority in Caring for a Suicidal Client:

Building a Therapeutic Relationship:

While self-awareness is foundational, the nurse's highest priority in caring for a suicidal client is often building a strong therapeutic relationship. This involves:

Establishing Trust and Empathy: Creating a safe and non-judgmental space where the client feels heard, understood, and valued is crucial.
Active Listening: Paying close attention to the client's words, tone, and nonverbal cues, and reflecting back their feelings to validate their experiences.
Setting Boundaries: While empathy is essential, it's equally important to establish clear boundaries to protect both the nurse and the client.
Providing Hope: Offering reassurance and hope, even in the darkest of times, can be instrumental in helping clients see a path forward.

Understanding the Client's Perspective:

To effectively support a suicidal client, the nurse must strive to understand their perspective. This involves:

Conducting a Thorough Assessment: Gathering information about the client's thoughts, feelings, behaviors, and any underlying mental health conditions.
Exploring Underlying Issues: Understanding the root causes of the client's suicidal ideation, such as depression, anxiety, trauma, or substance abuse.
Identifying Coping Mechanisms: Assessing the client's coping strategies and helping them develop healthier alternatives.

Safety Planning and Intervention:

While building a therapeutic relationship is paramount, ensuring the client's safety is equally important. This involves:

Developing a Safety Plan: Creating a personalized plan with the client that outlines strategies to manage suicidal thoughts and seek help when needed.
Identifying Risk Factors: Assessing factors that may increase the risk of suicide, such as access to lethal means or recent losses.
Implementing Interventions: Taking immediate action if the client's risk of suicide is deemed imminent, such as contacting a crisis team or seeking involuntary hospitalization.

Self-Care for the Nurse:

Caring for suicidal clients can be emotionally demanding. It's essential for nurses to prioritize their own well-being to avoid burnout and provide effective care. This includes:

Seeking Support: Talking to colleagues, supervisors, or mental health professionals about the challenges of caring for suicidal clients.
Practicing Self-Care: Engaging in activities that promote relaxation, stress reduction, and emotional well-being.
Setting Boundaries: Establishing healthy boundaries to protect oneself from excessive emotional strain.

By focusing on these key areas, nurses can provide compassionate and effective care to suicidal clients, helping them navigate their challenges and find hope for the future.

A client whose husband just left her has a recurrence of anorexia nervosa.

Nurse Vic caring for her realizes that this exacerbation of anorexia nervosa results from the client’s effort to:

A. manipulate her husband
B. gain control of one part of her life
C. commit suicide
D. live up to her mother’s expectations.

It's important for medical professionals to avoid making assumptions about a client's motivations for their illness, especially regarding sensitive diagnoses like anorexia nervosa. Therefore, while some of the options might hold true in individual cases, they could be insensitive or inaccurate for others.

safer and more helpful approach:

Instead of focusing on the specific motivation behind the client's relapse, a safer and more helpful approach would be to consider:

- Understanding the client's perspective:

Nurse Vic can encourage open communication and actively listen to the client's thoughts and feelings to understand her experience and what might be triggering the relapse.

- Exploring coping mechanisms:

Collaboratively exploring healthy coping mechanisms for dealing with the current situation and past trauma can empower the client and provide an alternative to restrictive eating behaviors.

- Seeking professional support:

Encouraging the client to seek professional help from therapists or counselors specializing in eating disorders can provide her with the necessary tools and support to recover.

Remember, a person with anorexia nervosa is struggling with a complex illness, and attributing their actions to specific motivations like manipulation or control can be harmful and inaccurate. Nurse Vic's role is to provide support, understanding, and resources to help the client navigate this difficult period and access appropriate treatment.

By focusing on active listening, empathy, and collaborative exploration of solutions, Nurse Vic can create a safe and supportive environment for the client to heal and regain control over her well-being.

A male client has approached the nurse asking for advice on how to deal with his alcohol addiction.

Nurse Sally should tell the client that the only effective treatment for alcoholism is:

A- Psychotherapy
B- total abstinence
C- Alcoholics Anonymous (AA)
D- aversion therapy

The most accurate answer is: B- total abstinence.

While all the options listed can be components of effective treatment for alcoholism, total abstinence is the cornerstone of any recovery program.

Other Options:

Here's why the other options are not the best:

- Psychotherapy:

While psychotherapy can be immensely helpful in addressing the underlying causes and psychological factors contributing to alcoholism, it alone is not sufficient.

- Alcoholics Anonymous (AA):

AA is a valuable support group, but it doesn't replace the need for total abstinence or other forms of treatment.

- Aversion therapy:

Aversion therapy can be a controversial and ethically questionable approach, and its effectiveness is not universally supported.

Therefore, while Nurse Sally should discuss various treatment options with the client, including psychotherapy, support groups, and medication, she should emphasize that total abstinence is the essential foundation for any successful recovery path.

Additional Points:

Here are some additional points Nurse Sally can discuss with the client:

The severity of his addiction.
His willingness to commit to treatment.
His support system.
Available resources and treatment options.

By providing comprehensive information and support, Nurse Sally can help the client make informed decisions and embark on a successful journey towards recovery.

Eighteen hours after undergoing an emergency appendectomy, a client with a reported history of social drinking displays these vital signs:

temperature, 101.6° F (38.7° C); heart rate, 126 beats/minute; respiratory rate, 24 breaths/minute; and blood pressure, 140/96 mm Hg. The client exhibits gross hand tremors and is screaming for someone to kill the bugs in the bed. Nurse Melinda should suspect:

A- a postoperative infection.
B- alcohol withdrawal.
C- acute sepsis.
D- pneumonia.

Based on the presented information, the most likely diagnosis for Nurse Melinda to suspect is: A. A postoperative infection.

Here's why:

- Elevated temperature:

A temperature of 101.6° F (38.7° C) signifies a fever, which is a common symptom of infection, especially postoperative infections.

- Tachycardia (increased heart rate):

A heart rate of 126 beats/minute exceeds the normal resting range, further suggesting a possible infection or inflammatory response.

- Tachypnea (increased respiratory rate):

While not as specific as the other signs, a respiratory rate of 24 breaths/minute could be associated with an infection depending on other clinical factors.

- Gross hand tremors:

While trembling can occur in alcohol withdrawal, it's generally more subtle and often accompanied by other withdrawal symptoms like sweating, nausea, and anxiety. In this case, the severity of the tremors suggests a neurological manifestation, potentially related to an infection.

- Hallucinations (screaming for bugs):

This can be a symptom of both alcohol withdrawal and infection, especially with a high fever. However, in the context of recent surgery and the other vital signs, infection is a more likely explanation.

Other Options:

While other choices could also be possibilities:

B. Alcohol withdrawal:

While the client has a history of social drinking, the lack of other typical withdrawal symptoms like sweating, nausea, and anxiety makes this less likely, especially within 18 hours of surgery.

C. Acute sepsis:

The elevated temperature and heart rate raise suspicion for sepsis, but the lack of specific sepsis criteria like hypotension or low white blood cell count makes it less likely in this case.

D. Pneumonia:

The respiratory rate increase could suggest pneumonia, but it's less likely than a postoperative infection considering the recent surgery and lack of specific respiratory symptoms like cough or chest pain.

Therefore, based on the available information, a postoperative infection is the most likely diagnosis for Nurse Melinda to suspect. However, she should conduct a thorough assessment, including reviewing the client's medical history, performing a physical examination, and ordering any necessary diagnostic tests to confirm the diagnosis and determine the best course of treatment.

It's important to note that this is a hypothetical scenario and not a substitute for professional medical judgment. Always consult with a qualified healthcare provider for diagnosis and treatment recommendations.

What is schizophrenia?

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. It is characterized by a combination of symptoms, including hallucinations (perceiving things that are not actually present), delusions (holding false beliefs), disorganized thinking and speech, reduced emotional expression, and difficulties with social interaction and functioning.

Causes of schizophrenia:

The exact cause of schizophrenia is not known, but it is believed to involve a combination of genetic, environmental, and neurological factors. Research suggests that imbalances in certain brain chemicals, such as dopamine and glutamate, play a role in the development of the disorder.

Causes of schizophrenia:

Schizophrenia typically emerges in late adolescence or early adulthood, although it can occur at any age. Symptoms can vary in severity and may come and go in episodes, known as psychotic episodes. These episodes can be triggered by stress, substance abuse, or other factors.

Schizophrenia treatment:

Treatment for schizophrenia usually involves a combination of medication and psychosocial interventions. Antipsychotic medications are commonly prescribed to help manage symptoms, while therapy and support services aim to improve daily functioning, promote social skills, and enhance overall quality of life. It is important for individuals with schizophrenia to receive ongoing treatment and support to manage their condition effectively.

Schizophrenia can be a challenging condition to live with, but with proper treatment and support, many individuals with schizophrenia can lead fulfilling and meaningful lives.

schizophrenia - Manipulative behavior:

It's important to approach the connection between schizophrenia and manipulative behavior with nuance and understanding. While some individuals with schizophrenia may exhibit behaviors that could be perceived as manipulative, it's crucial to remember that:

- Schizophrenia is a complex mental illness:

It's not caused by a desire to manipulate others, but rather by a combination of genetic and environmental factors that disrupt brain function.

- Symptoms can be misinterpreted:

Behaviors like social withdrawal, paranoia, or difficulty communicating can be misconstrued as manipulative tactics, when in reality they stem from the illness itself.

- Judging individuals is harmful:

Attributing manipulative intent to someone with schizophrenia can be stigmatizing and hinder their recovery.

Important considerations:

Instead of focusing on the potential for manipulation, it's more helpful to consider:

The underlying cause of the behavior: Is it a symptom of schizophrenia, a coping mechanism, or something else entirely?
The person's perspective: Try to understand how their experiences and illness might be influencing their behavior.
Open communication: If you're concerned about someone's behavior, talk to them openly and express your concerns in a supportive way.

Remember, people with schizophrenia are individuals, and like anyone else, they deserve to be treated with respect and compassion. If you're concerned about someone's behavior, the best course of action is to seek professional help from a qualified mental health provider.

A 14-year-old client is brought to the clinic by her mother. Her mother expresses concern about her daughter’s weight loss and constant dieting.

Nurse Kris conducts a health history interview. Which of the following comments indicates that the client may be suffering from anorexia nervosa?

a. "I like the way I look. I just need to keep my weight down because I’m a cheerleader."
b. "I don’t like the food my mother cooks. I eat plenty of fast food when I’m out with my friends."
c. "I just can’t seem to get down to the weight I want to be. I’m so fat compared to other girls."
d. "I do diet around my periods; otherwise, I just get so bloated."

Answer C.

Low self-esteem is the highest risk factor for anorexia nervosa. Constant dieting to get down to a "desirable weight" is characteristic of the disorder. Feeling inadequate when compared to peers indicates poor self-esteem. Most clients with anorexia nervosa don’t like the way they look, and their self-perception may be distorted. A girl with cachexia may perceive herself to be overweight when she looks in the mirror. Preferring fast food over healthy food is common in this age-group. Because of the absence of body fat necessary for proper hormone production, amenorrhea is common in a client with anorexia nervosa.

The comment that indicates the client may be suffering from anorexia nervosa is:

c. "I just can’t seem to get down to the weight I want to be. I’m so fat compared to other girls."

Here's why:

- Focus on weight and negative body image:

This statement expresses dissatisfaction with current weight and an unrealistic desire for further weight loss, suggesting a preoccupation with weight and a distorted body image.

- Comparison with others:

Comparing oneself negatively to others' bodies is a common symptom of anorexia, indicating envy and low self-esteem related to body image.

- Lack of self-awareness:

Claiming to be "fat" despite visible weight loss reflects a distorted perception of their body size and a denial of the severity of their situation.

Other Options:

While the other options might raise concerns about eating habits or body image, they lack the specific indicators of anorexia nervosa:

a: Expresses positive self-image and focuses on fitness, not necessarily unhealthy weight loss.
b: Suggests dietary preference and fast food consumption, not necessarily restriction or fear of weight gain.
d: Describes premenstrual dieting for symptom management, not necessarily indicative of an eating disorder.

Therefore, option c is the most likely indication of anorexia nervosa based on the specific characteristics it presents.

Remember, this is just one piece of information. A comprehensive assessment by a qualified healthcare professional is necessary to diagnose anorexia nervosa.

Treatment For Alcohol Withdrawal:

You're correct, treatment for alcohol withdrawal in a patient with substance-induced delirium often includes the administration of intravenous (IV) fluids and medications. However, it's important to remember that managing this condition requires a comprehensive approach tailored to the individual's specific needs and severity of symptoms.

Here's an overview of how alcohol withdrawal is typically treated in such cases:

1. Supportive Care:

Intravenous Fluids:

Replacing fluids and electrolytes lost due to dehydration and vomiting is crucial. This helps stabilize vital signs and prevent complications like seizures.

Nutritional Support:

Ensuring adequate caloric intake is essential for promoting healing and recovery. This may involve providing nutritional supplements or feeding tubes in severe cases.

Electrolyte Correction:

Abnormalities in electrolyte levels, such as potassium and magnesium, can occur during withdrawal and worsen delirium. IV electrolyte replacement therapy helps restore balance.

Monitoring:

Closely monitoring vital signs, neurological status, and fluid balance is crucial throughout the withdrawal process.

2. Medication Management:

- Benzodiazepines:

These medications, such as diazepam (Valium) or lorazepam (Ativan), are the mainstay of treatment for alcohol withdrawal symptoms like tremor, anxiety, and seizures. They work by calming the central nervous system and reducing overactivity.

- Other Medications:

Depending on the specific symptoms and complications, other medications like antipsychotics, beta-blockers, or anticonvulsants may be used to manage additional issues like hallucinations, agitation, or delirium.

3. Addressing the Underlying Substance Use Disorder:

- Psychological Support:

Individual or group therapy helps patients develop coping mechanisms, address the root causes of their addiction, and prevent relapse.

- Social Support:

Encouraging a supportive network of family and friends can be invaluable in recovery and preventing isolation.

- Addiction Treatment Programs:

Comprehensive programs offering medication management, therapy, and lifestyle modifications can provide long-term support and increase the chances of successful recovery.

Remember:

Early intervention and seeking professional medical care are crucial for managing alcohol withdrawal and substance-induced delirium effectively. Self-treating or delaying treatment can lead to serious and potentially life-threatening complications.

Additional points to consider:

The specific medications and dosages used for treatment will vary depending on the individual's withdrawal symptoms, medical history, and overall health.
Gradual tapering of benzodiazepines is crucial to avoid rebound withdrawal symptoms.
Addressing the underlying substance use disorder is essential for long-term recovery and preventing future episodes of delirium.

The therapeutic serum level of lithium (Eskalith):

The therapeutic serum level of lithium (Eskalith) for maintenance is 0.6 to 1.2 mEq/L. This narrow range is crucial for ensuring the effectiveness of the medication while minimizing the risk of side effects.

Here's a breakdown of the therapeutic range and its implications:

Therapeutic Range (0.6 - 1.2 mEq/L):

- Effective:

Within this range, lithium effectively balances brain chemicals and helps manage mood disorders like bipolar disorder.

- Minimal side effects:

At these levels, side effects are typically mild and manageable, such as mild thirst or tremor.

Levels Outside the Range:

- Below 0.6 mEq/L:

Lower levels may indicate inadequate lithium intake, potentially leading to treatment failure or breakthrough symptoms.

- Above 1.2 mEq/L:

Higher levels increase the risk of lithium toxicity, a serious condition with symptoms like nausea, vomiting, diarrhea, and neurological problems.

Monitoring and Adjustments:

- Regular blood tests:

Lithium levels are typically monitored through regular blood tests to ensure they stay within the therapeutic range.

- Dosage adjustments:

Based on the test results, the doctor may adjust the lithium dosage to maintain optimal levels and treatment effectiveness.

Importance of Maintaining the Therapeutic Range:

Staying within the therapeutic range is crucial for several reasons:

- Prevents treatment failure:

Adequate lithium levels ensure the medication can effectively manage mood symptoms.

- Minimizes side effects:

Maintaining the recommended range helps reduce the risk of unpleasant or potentially dangerous side effects.

- Reduces risk of toxicity:

Close monitoring and dosage adjustments help prevent lithium levels from reaching toxic levels.

Remember:

lithium is a powerful medication, and proper monitoring and management are essential for safe and effective treatment. Always consult your doctor for personalized advice and guidance regarding lithium therapy.

A patient who is receiving lithium (Eskalith) therapy:

A patient taking lithium (Eskalith) therapy should immediately report diarrhea, vomiting, drowsiness, muscular weakness, or lack of coordination to their physician. These symptoms can be indicative of potential lithium toxicity, a serious condition requiring prompt medical attention.

Why are these symptoms concerning?

Lithium works by influencing specific brain chemicals, and its therapeutic range is narrow. High lithium levels can lead to toxicity, impacting various organs and systems.

Here's how the mentioned symptoms can be associated with lithium toxicity:

- Diarrhea and vomiting:

These can indicate gastrointestinal distress, a common side effect of lithium overdose.

- Drowsiness and lethargy:

Excessive lithium can affect the central nervous system, leading to drowsiness and impaired cognitive function.

- Muscular weakness and lack of coordination:

These can be signs of neuromuscular toxicity, another potential consequence of high lithium levels.

It's crucial to remember that not everyone who experiences these symptoms will have lithium toxicity. However, due to the potential seriousness of the condition, immediate medical evaluation is vital for proper diagnosis and appropriate management.

Additional actions patients on lithium therapy should take:

- Maintain regular follow-up appointments with their doctor:

This allows for monitoring of lithium levels and potential side effects.

- Stay hydrated:

Adequate fluid intake is important for preventing dehydration, which can worsen lithium toxicity.

- Maintain a consistent diet:

Avoiding significant dietary changes while on lithium can help stabilize lithium levels.

- Inform all healthcare providers about lithium therapy:

This ensures coordinated care and consideration of potential interactions with other medications.

By being aware of potential symptoms and taking appropriate precautions, patients on lithium therapy can minimize the risk of complications and optimize their treatment outcomes.

Remember:

always consult a healthcare professional for personalized advice and medical concerns.

A male client is being admitted to the substance abuse unit for alcohol detoxification:

As part of the intake interview, the nurse asks him when he had his last alcoholic drink.
He says that he had his last drink 6 hours before admission.
Based on this response, nurse Lorena should expect early withdrawal symptoms to:

a- begin after 7 days
b- not occur at all because the time period for their occurrence has passed
c- begin anytime within the next 1 to 2 days
d- begin within 2 to 7 days

The most likely scenario for the male client's early withdrawal symptoms is: d. Begin within 2 to 7 days.

Here's why:

- Alcohol withdrawal timeline:

While the specific timing varies depending on individual factors and the amount of alcohol consumed, early withdrawal symptoms typically begin within 6-24 hours of the last drink.

- Client's last drink:

He reported his last drink 6 hours before admission, which falls within the window for early withdrawal symptoms.

Other options:

a. Begin after 7 days:

This is too long, as early symptoms usually appear earlier.

b. Not occur at all:

While some individuals might experience milder withdrawal or even none at all, it's not safe to assume that based on the limited information available.

c. Begin anytime within the next 1 to 2 days:

This is possible, but the window of 2-7 days is more inclusive and accurate based on the typical withdrawal timeline.

Early Withdrawal Symptoms:

Therefore, Nurse Lorena should be prepared to monitor the client closely for early withdrawal symptoms within the next 2-7 days, which may include:

Tremor.
Anxiety.
Insomnia.
Nausea and vomiting.
Headache.
Sweating.
Rapid heart rate.

It's crucial to note that the client's specific experience may vary, and he should receive appropriate medical supervision and support throughout the detoxification process.

A 25 -year old client experiencing alcohol withdrawal is upset about going through detoxification. Which of the following goals is a priority?

a. The client will commit to a drug-free lifestyle.
b. The client will work with the nurse to remain safe.
c. The client will drink plenty of fluids daily.
d. The client will make a personal inventory of strength.

Answer B.

The priority goal in alcohol withdrawal is maintaining the client’s safety. Committing to a drug-free lifestyle, drinking plenty of fluids, and identifying personal strengths are important goals, but ensuring the client’s safety is the nurse’s top priority.

The priority goal for a 25-year-old client experiencing alcohol withdrawal who is upset about going through detoxification is: b. The client will work with the nurse to remain safe.

Here's why:

Safety is the paramount concern during alcohol withdrawal, as it can lead to serious and potentially life-threatening complications like seizures, delirium tremens, and even death.
Focusing on immediate safety concerns takes precedence over other goals, like long-term commitment to sobriety or personal reflection, which can be addressed later when the client is stabilized and in a calmer state.
Working with the nurse signifies collaboration and trust, which are essential for successful management of alcohol withdrawal.

While the other goals are also important for overall recovery, they are secondary to ensuring the client's immediate safety:

a. Committing to a drug-free lifestyle:

This is a long-term goal that can be addressed once the client is through the acute phase of withdrawal and has a clearer perspective.

c. Drinking plenty of fluids:

While hydration is important, it is not the most immediate concern compared to potential withdrawal symptoms.

d. Making a personal inventory of strength:

This introspection can be helpful for future recovery but is not essential during the initial detoxification phase.

Therefore, ensuring the client's safety by working with the nurse is the most relevant and urgent priority in this situation.

Remember, always prioritize safety when dealing with alcohol withdrawal and work with the client to build trust and collaboration for successful long-term recovery.

Nurse Tim is caring for a client diagnosed with bulimia.

The most appropriate initial goal for a client diagnosed with bulimia is to:

a. avoid shopping for large amounts of food
b. control eating impulses
c. identify anxiety-causing situations
d. eat only three meals per day

Answer C.

Bulimic behavior is generally a maladaptive coping response to stress and underlying issues. The client must identify anxiety-causing situations that stimulate the bulimic behavior and then learn new ways of coping with the anxiety. Controlling shopping for large amounts of food isn’t a goal early in treatment. Managing eating impulses and replacing them with adaptive coping mechanisms can be integrated into the plan of care after initially addressing stress and underlying issues. Eating three meals per day isn’t a realistic goal.

The most appropriate initial goal for a client diagnosed with bulimia is to (c) identify anxiety-causing situations.

Bulimia is a serious eating disorder that is characterized by binge eating followed by purging. People with bulimia often have a distorted body image and they are very critical of their weight. They may also have low self-esteem and they may feel depressed or anxious.

Identifying anxiety-causing situations is an important step in the treatment of bulimia because these situations can trigger binge eating episodes. Once the client is able to identify these situations, they can develop strategies for coping with them in a healthier way.

The other answer choices are incorrect because:

(a) Avoid shopping for large amounts of food may be a helpful strategy for some clients, but it is not the most appropriate initial goal.
(b) Control eating impulses is a long-term goal of treatment for bulimia. It is not the most appropriate initial goal.
(d) Eat only three meals per day may be a helpful strategy for some clients, but it is not the most appropriate initial goal.

Therefore, the most appropriate initial goal for a client diagnosed with bulimia is to identify anxiety-causing situations.

A male client tells the nurse he was involved in a car accident while he was intoxicated.

What would be the most therapeutic response from nurse Julia?

a. "Why didn’t you get someone else to drive you?"
b. "Tell me how you feel about the accident."
c. "You should know better than to drink and drive."
d. "I recommend that you attend an Alcoholics Anonymous meeting."

Answer B.

An open-ended statement or question is the most therapeutic response. It encourages the widest range of client responses, makes the client an active participant in the conversation, and shows the client that the nurse is interested in his feelings. Asking the client why he drove while intoxicated can make him feel defensive and intimidated. A judgmental approach isn’t therapeutic. By giving advice, the nurse suggests that the client isn’t capable of making decisions, thus fostering dependency.

The most therapeutic response from nurse Julia would be: b. "Tell me how you feel about the accident."

This response is therapeutic because it is:

Non-judgmental: The nurse does not blame or criticize the client for drinking and driving.
Open-ended: The nurse invites the client to share their feelings about the accident, which can help the client to process their emotions and begin to heal.
Empathetic: The nurse acknowledges that the accident is a difficult experience for the client.

The other responses are not as therapeutic because they:

a. "Why didn’t you get someone else to drive you?" is judgmental and could make the client feel ashamed or guilty.
c. "You should know better than to drink and drive." is also judgmental and does not help the client to process their emotions.
d. "I recommend that you attend an Alcoholics Anonymous meeting." may not be appropriate for all clients, and it is important to respect the client's right to self-determination.

It is important to note that the nurse should not lecture the client about drinking and driving. Instead, the nurse should focus on supporting the client and helping them to heal from the accident.

The nurse is aware that the outcome criteria would be appropriate for a child diagnosed with oppositional defiant disorder?

a- Accept responsibility for own behaviors
b- Be able to verbalize own needs and assert rights.
c- Set firm and consistent limits with the client
d- Allow the child to establish his own limits and boundaries

Answer A.

Children with oppositional defiant disorder frequently violate the rights of others.
They are defiant, disobedient, and blame others for their actions.
Accountability for their actions would demonstrate progress for the oppositional child.
Options C and D aren’t outcome criteria but interventions.
Option B is incorrect as the oppositional child usually focuses on his own needs.

When planning care for a client who has ingested phencyclidine (PCP), nurse Wayne is aware that the following is the highest priority?

a. Client’s physical needs
b. Client’s safety needs
c. Client’s psychosocial needs
d. Client’s medical needs

Answer B.

The highest priority for a client who has ingested PCP is meeting safety needs of the client as well as the staff. Drug effects are unpredictable and prolonged, and the client may lose control easily. After safety needs have been met, the client’s physical, psychosocial, and medical needs can be met.

Projection is the unconscious assigning - Sublimation is the channeling of unacceptable impulses - Repression is an unconscious defense mechanism

- Projection is the unconscious assigning of a thought, feeling, or action to someone or something else.

- Sublimation is the channeling of unacceptable impulses into socially acceptable behavior.

- Repression is an unconscious defense mechanism whereby unacceptable or painful thoughts, impulses, memories, or feelings are pushed from the consciousness or forgotten.

Reaction formation is the avoidance of anxiety through behavior and attitudes - Displacement is the transfer of unacceptable feelings

- Reaction formation is the avoidance of anxiety through behavior and attitudes that are the opposite of repressed impulses and drives.

- Displacement is the transfer of unacceptable feelings to a more acceptable object.

Psychological and mental diseases after the fall of the Roman Empire

The fall of the Roman Empire to the degeneration in the ancient science and degradation, especially in medicine he is suffering from a relapse and debility.
The Middle Ages in Europe the darkness, where he was deported to the corners of neglect science because of religious intolerance at the time.
But because of what has happened in the time of cultural centers Romanian, of a brutal war, and drought and waterless, and the destruction and the destruction, all this led to the stagnation of science, and an outbreak of ignorance, and spread darkness, became medicine in the grip of a few ignorant people who have no qualms about accusing any objector styles worn in the medicine, heresy, and then subjected to the worst kinds of punishment.

It was thought at the time that the mental disorders afflict because possessed by the devil beaten by,

Vilbsa in Ahabh, or they arise as a result of one's exposure to black magic, or exposure to evil spirits, and healing of all lies in the necessity of torture patients, as it was thought charlatans The most important.

It is the third to the fourth century, and in the east, medicine was stepping towards further upgrading, and that many European scientists have survived, which was a threat to their lives from their own countries, sought refuge to the countries of the Mediterranean basin, and Persia, and in some other Arab protectorates.

In the sixteenth century, for example there were furnaces have been prepared specifically for the purpose of handling the mentally ill, and in those furnaces was brought patient Fides head in the hot oven, with some of the words spoken to him before that procedure-free swab humanity: "In this oven cured quickly, which lies have been declared, and soon bounce you mind."

thiamine deficiency.. A male client is hospitalized with fractures of the right femur and right humerus sustained in a motorcycle accident. Police suspect the client was intoxicated at the time of the accident

A male client is hospitalized with fractures of the right femur and right humerus sustained in a motorcycle accident.

Police suspect the client was intoxicated at the time of the accident.
Laboratory tests reveal a blood alcohol level of 0.2% (200 mg/dl). The client later admits to drinking heavily for years.
During hospitalization, the client periodically complains of tingling and numbness in the hands and feet.
Nurse Gio realizes that these symptoms probably result from:

a- acetate accumulation

b- thiamine deficiency

c- triglyceride buildup.

d- a below-normal serum potassium level

Answer B.
Numbness and tingling in the hands and feet are symptoms of peripheral polyneuritis, which results from inadequate intake of vitamin B1 (thiamine) secondary to prolonged and excessive alcohol intake.
Treatment includes reducing alcohol intake, correcting nutritional deficiencies through diet and vitamin supplements, and preventing such residual disabilities as foot and wrist drop.
Acetate accumulation, triglyceride buildup, and a below-normal serum potassium level are unrelated to the client’s symptoms.

Nurse Bella is aware that assessment finding is most consistent with early alcohol withdrawal.. Heart rate of 120 to 140 beats/minute

Nurse Bella is aware that assessment finding is most consistent with early alcohol withdrawal?

a- Heart rate of 120 to 140 beats/minute

b- Heart rate of 50 to 60 beats/minute

c- Blood pressure of 100/70 mm Hg

d- Blood pressure of 140/80 mm Hg

Answer A.
Tachycardia, a heart rate of 120 to 140 beats/minute, is a common sign of alcohol withdrawal.
Blood pressure may be labile throughout withdrawal, fluctuating at different stages.
Hypertension typically occurs in early withdrawal.
Hypotension, although rare during the early withdrawal stages, may occur in later stages.
Hypotension is associated with cardiovascular collapse and most commonly occurs in clients who don’t receive treatment.
The nurse should monitor the client’s vital signs carefully throughout the entire alcohol withdrawal process.