NURS 218 Personal Care of Head Emergencies at Baton Rouge Community College
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Free NURS 218 Personal Care of Head Emergencies at Baton Rouge Community College Questions
Which intervention should the nurse include when planning care for a patient diagnosed as having Histrionic Personality Disorder?
- Accept the behavior as positive
- Set firm limits on attention-seeking behaviors
- Emphasize passive-aggressive behavior
- Accept the patient’s provocative behavior
Explanation
Histrionic Personality Disorder (HPD) is characterized by attention-seeking, dramatic, and sometimes provocative behaviors. It is essential for the nurse to set firm, clear limits on these behaviors to prevent manipulation and to encourage appropriate and respectful interactions. By setting limits, the nurse helps the patient understand boundaries, and this fosters healthier interpersonal interactions. It is important not to reinforce attention-seeking behaviors but to guide the patient towards more appropriate ways of seeking attention.
A nurse is caring for a patient diagnosed with avoidant personality disorder. Which behavior could impede this patient's ability to establish close interpersonal relationships?
- Fear of rejection
- Anger and aggression
- Exploitation of others
- Lack of empathy
Explanation
A hallmark of avoidant personality disorder is an intense fear of rejection or criticism, which can prevent the individual from initiating or maintaining close interpersonal relationships. This fear leads to feelings of inadequacy, social inhibition, and avoidance of social situations, all of which can make it difficult for the person to form meaningful connections with others. They often avoid relationships to protect themselves from perceived rejection.
A college student who failed two tests cried for hours and then tried to telephone a parent but got no answer. The student then gave several expensive sweaters to a roommate and asked to be left alone for a few hours. Which behavior provides the strongest clue of an impending suicide attempt?
- Excessive crying
- Giving away sweaters
- Staying alone in dorm room
- Calling parents
Explanation
Giving away personal belongings, especially valued items like expensive sweaters, is often seen as a significant warning sign of suicidal intent. It may indicate that the individual feels a sense of finality or detachment and is preparing for something irreversible. This behavior suggests that the person may be contemplating suicide, as they are symbolically "letting go" of possessions that hold personal value. This act is a strong indicator that immediate intervention is needed.
A child has been placed on central nervous system (CNS) stimulants for attention-deficit hyperactivity disorder (ADHD). The nurse should include which side effects of the medication while teaching the parents?
- Growth retardation, urinary retention, and bradycardia
- Nervousness, nausea and vomiting, and dystonia
- Headache, insomnia, and possible growth retardation
- Bradycardia, weight gain, and insomnia
Explanation
CNS stimulants, such as methylphenidate and amphetamines, are commonly prescribed for ADHD. The most common side effects include headache, insomnia (difficulty sleeping), and potential growth retardation (slowed growth or weight gain). These side effects occur due to the stimulating effects of the medication on the central nervous system. Parents should be made aware of these potential side effects and should monitor the child's response to medication, including any changes in growth patterns or sleep disturbances.
A suicidal client is placed on one-to-one observation. When the nurse accompanies the client to the bathroom, the client loudly states, "I'm sick of being followed around and treated like a child who has misbehaved and cannot be trusted." Which statement would be the best therapeutic response by the nurse?
- "Since this is upsetting to you, leave the door open and I'll wait outside for you."
- "Being angry and uncooperative will not change anything. I can't leave a suicidal client alone."
- "You don't have to shout. I trust you, but I cannot change the rules for you."
- "I understand that you do not like this, but I must be able to see you at all times to make sure you are safe."
Explanation
This response is therapeutic because it acknowledges the client's feelings while reinforcing the rationale for the safety measures. The nurse empathizes with the client’s frustration and clarifies the necessity of the observation for the client's safety due to the risk of suicide. It maintains a balance of compassion and professionalism, helping to foster trust while emphasizing the importance of safety protocols.
A client with attention-deficit hyperactivity disorder is assessed by a nurse. Which assessment findings are expected? Select all that apply.
- Distractibility
- Increased attention to detail
- Increased level of activity
- A history of accidental injuries
- Reluctance to talk
- Impulsiveness
Explanation
A. Distractibility Distractibility is a hallmark symptom of ADHD. Individuals with ADHD often have difficulty staying focused on tasks or activities, leading them to become easily distracted by external stimuli or irrelevant thoughts. This constant shifting of attention interferes with their ability to complete tasks, whether at school, work, or home.
C. Increased level of activity Hyperactivity is a core feature of ADHD. This manifests as an excessive need for movement or fidgeting, difficulty staying still, and being constantly on the go. This increased level of activity can be evident in both children and adults with ADHD and may result in challenges in situations that require prolonged focus or calm behavior, such as in classrooms or meetings.
D. A history of accidental injuries Due to impulsivity and hyperactivity, individuals with ADHD are at an increased risk of accidents. They may act without considering the consequences, making them more prone to injuries. Additionally, their constant movement and inability to focus on safety can lead to frequent accidents or mishaps, which can be reflected in a history of injuries.
F. Impulsiveness Impulsivity is a central feature of ADHD. This can lead to actions taken without thinking through the consequences, such as interrupting others, making decisions without adequate consideration, or engaging in risky behaviors. Impulsive behaviors can also extend to difficulty waiting for one's turn or acting inappropriately in social situations.
The nurse is assigned to a patient diagnosed with antisocial personality disorder who frequently manipulates others. Which intervention is appropriate?
- Encourage the patient to discuss feelings of fear and inferiority
- Refer requests and questions related to care to the case manager
- Provide negative reinforcement for acting-out behavior
- Ignore, rather than confront, inappropriate behavior
Explanation
Patients with antisocial personality disorder often manipulate others and disregard the rights of others. One effective intervention is to refer the patient’s requests or questions to the case manager. This helps limit opportunities for manipulation and ensures that the care team remains consistent in enforcing boundaries and guidelines. By limiting direct interactions, the nurse can help reduce the potential for the patient to manipulate situations to their advantage.
Prescribed: Fluoxetine liquid 15 mg po BID
Available: Fluoxetine 20 mg/5 mL
How many mL will the nurse administer per dose?
- 3.8 mL
- 4.0 mL
- 3.5 mL
- 2.5 mL
Explanation
1. Determine the dose in mg per dose.
Prescribed: 15 mg po BID (twice daily) → dose = 15 mg.
2. Concentration available:
20 mg / 5 mL means 20 mg in every 5 mL.
3. Set up proportion:
20 mg:5 mL=15 mg:x mL
20 mg:5 mL=15 mg:x mL
20x=15×5
20x=15×5
20x=75
20x=75
x=75/20=3.75 mL
4. Round to the nearest tenth:
3.75 mL → 3.8 mL
A nurse is caring for a client following a total laryngectomy. Which of the following is the priority nursing problem for the client?
- Patency of the intravenous line
- Need for suctioning
- Integrity of the dressing
- Level of pain
Explanation
After a total laryngectomy, ensuring airway patency is the priority. The patient will likely have a tracheostomy or a stoma, and suctioning is necessary to clear any mucus or secretions that could obstruct the airway. Difficulty breathing or labored breathing due to secretions can quickly become a life-threatening situation, so suctioning to clear the airway takes precedence over other concerns.
A rape victim says to the nurse, "I always try to be so careful. I know I should not have walked to my car alone. Was this attack my fault?" Which communication by the nurse is most therapeutic?
- Support the victim to separate issues of vulnerability from blame
- Pose questions about the rape and help the patient explore why it happened
- Emphasize the importance of using a buddy system in public places
- Reassure the victim that the outcome of the situation will be positive
Explanation
The most therapeutic response is to help the victim separate their feelings of vulnerability from the false belief that they are to blame for the assault. It’s important to reassure the patient that they are not responsible for the violence that occurred, regardless of their actions or decisions. The nurse should validate the victim's feelings, while emphasizing that the responsibility for the rape lies with the perpetrator, not the victim.
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