NURS 218 Psychotic Bipolar TPN HA Seizures at Baton Rouge General School of Nursing
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Free NURS 218 Psychotic Bipolar TPN HA Seizures at Baton Rouge General School of Nursing Questions
Which nursing diagnosis is most appropriate during the postictal phase of a seizure?
- Risk for infection
- Disturbed sensory perception
- Acute confusion
- Impaired memory
Explanation
C. Acute confusion
During the postictal phase, patients commonly experience disorientation, confusion, lethargy, and impaired awareness as the brain recovers from seizure activity. This period may last minutes to hours. Acute confusion is the most appropriate diagnosis because it directly reflects the immediate and expected neurologic recovery state following a seizure.
Correct Answer Is:
C. Acute confusion
Prescribed: Acyclovir 12 mg/kg PO daily Available: Acyclovir 100 mg / 2 mL Patient weight: 115 lb How many mL will the nurse administer per dose? Record your answer to the tenth.
- 6.2 mL
- 9.8 mL
- 12.5 mL
- 15.4 mL
Explanation
First convert the patient’s weight from pounds to kilograms: 115 lb ÷ 2.2 = 52.3 kg Next calculate the prescribed dose: 12 mg × 52.3 kg = 627.6 mg Determine concentration of available medication: 100 mg in 2 mL → 50 mg per mL Now calculate required volume: 627.6 mg ÷ 50 mg/mL = 12.55 mL Rounded to the nearest tenth = 12.5 mL Therefore, the nurse should administer 12.5 mL per dose.
Correct Answer Is:
C. 12.5 mL
The nurse is planning the care for the client in the image who is experiencing a hallucination. What is the first nursing intervention for this client? A Use a group of several staff to provide comfort to the client. B Provide support to the client with touch and reassurance. C Consider the need for medications that may console the client. D Have one or two staff reinforce that the client is safe.
- A Use a group of several staff to provide comfort to the client.
- B Provide support to the client with touch and reassurance.
- C Consider the need for medications that may console the client.
- D Have one or two staff reinforce that the client is safe.
Explanation
D. Have one or two staff reinforce that the client is safe.
The first priority with a hallucinating client is to reduce stimuli and provide calm, simple reassurance. Approaching the client with one or two staff prevents overwhelming them and promotes a sense of safety. Using clear, supportive statements helps ground the client and decreases fear associated with hallucinations.
Correct Answer Is:
D. Have one or two staff reinforce that the client is safe.
A nurse is caring for a patient on an acute mental health unit. The patient reports hearing voices that are stating, “kill your doctor.” Which action should the nurse take first?
- Initiate one-to-one observation of the client.
- Encourage the client to participate in group therapy on the unit.
- Notify the provider of the client’s statement.
- Focus the client on reality.
Explanation
A. Initiate one-to-one observation of the client
Command hallucinations that direct a patient to harm someone represent an immediate safety emergency. The nurse’s first action must be to protect the client, staff, and others by placing the patient on one-to-one observation. This ensures constant supervision, prevents potential violence, and allows the nurse to monitor changes in behavior while further interventions are arranged.
Correct Answer Is:
A. Initiate one-to-one observation of the client.
The patient tells the RN that she “takes a lot of Tylenol” for a bad headache. The RN should caution the patient to take no more than ___ tablets per 24 hours. (Refer to the image: Tylenol Extra Strength, 500 mg per tablet)
- 4 tablets
- 6 tablets
- 8 tablets
- 10 tablets
Explanation
Tylenol Extra Strength contains 500 mg of acetaminophen per tablet. The maximum safe adult dose of acetaminophen is 4,000 mg (4 g) in 24 hours. To calculate the safe tablet limit: 4,000 mg ÷ 500 mg = 8 tablets Taking more than 8 tablets in 24 hours increases the risk of liver toxicity and acute liver injury. Staying within the recommended limit helps ensure safe pain management.
Correct Answer Is:
C. 8 tablets
During a manic episode, a client says to the nurse, “I hate you, I hate my life, I am going to beat something. I have so much anger right now.” Which statement by the nurse would be most effective at this time?
- “You are lucky, why do you say that?”
- “You should not feel that way.”
- “Did you get your medication today?”
- “You sound frustrated; can I help?”
Explanation
D. “You sound frustrated; can I help?”
This response acknowledges the client's feelings without judgment and uses therapeutic communication. It helps de-escalate anger, shows presence, and opens the door for the client to express emotions safely. It is calm, supportive, and non-confrontational, which is critical during a manic episode when agitation may escalate to aggression.
Correct Answer Is:
D. “You sound frustrated; can I help?”
A nurse is caring for a newly admitted patient experiencing mania. The nurse should recognize that which patient statement would provide the best supportive evidence of this diagnosis?
- “I can’t stop my sexual urges. They have led me to numerous affairs.”
- “I am the Messiah. I rule the world.”
- “The FBI has tapped my room and are out to get me.”
- “My wife is distraught about my overspending.”
Explanation
A. “I can’t stop my sexual urges. They have led me to numerous affairs.”
Hypersexuality, increased risky behaviors, and poor impulse control are classic symptoms of mania. Individuals in a manic episode often display heightened libido, impaired judgment, and impulsive behaviors such as sexual indiscretions. This statement best reflects a hallmark behavioral pattern of mania and provides strong supportive evidence for the diagnosis.
Correct Answer Is:
A. “I can’t stop my sexual urges. They have led me to numerous affairs.”
When caring for a patient with a seizure disorder who is hospitalized, which precaution would the nurse institute for someone with seizure precautions?
- Keep a tongue blade at the bedside
- Place oxygen and suction equipment at the bedside
- Monitor vital signs every 15 minutes
- Place patient in bilateral wrist restraints
Explanation
B. Place oxygen and suction equipment at the bedside
Seizure precautions require keeping oxygen and suction readily available. After a seizure, the patient may have airway obstruction from secretions or decreased level of consciousness. Suction helps clear the airway, and oxygen supports adequate ventilation. These actions prevent complications such as hypoxia, aspiration, and respiratory distress, making them essential parts of seizure precautions.
Correct Answer Is:
B. Place oxygen and suction equipment at the bedside
Use the drop-down lists to complete the sentences: The nurse provides medication education for a client prescribed lithium. The nurse instructs the client to 1 __________ and informs them of the need to monitor 2 __________. The nurse also recognizes that a 3 __________ would be a critical finding and should be reported to the health care provider. Which of the following options correctly completes the statements?
- 1 avoid foods with tyramine; 2 liver enzyme levels; 3 mild hand tremor
- 1 ensure adequate hydration and sodium intake; 2 lithium blood levels; 3 coarse tremor
- 1 eat a high-protein diet; 2 potassium levels; 3 drowsiness
- 1 avoid carbohydrates; 2 urine ketone levels; 3 weight loss
Explanation
Lithium requires consistent hydration and adequate sodium to prevent toxicity. Lithium blood levels must be monitored due to its narrow therapeutic index. A coarse tremor is an early sign of lithium toxicity and must be reported immediately.
Correct Answer Is:
B. 1 ensure adequate hydration and sodium intake; 2 lithium blood levels; 3 coarse tremor
A hospitalized patient has excessive talking, reports having an increased libido and a euphoric mood. The patient has not slept in days and is prescribed Lithium and Clozapine. What laboratory result would require immediate nursing intervention?
- Na – 136 mEq/L
- WBC – 2500/mm³
- Lithium level – 1.1 mEq/L
- K – 4.9 mEq/L
Explanation
B. WBC – 2500/mm³
A white blood cell count of 2500/mm³ indicates severe leukopenia, a dangerous adverse effect of clozapine. Clozapine can cause agranulocytosis, leaving the patient highly vulnerable to life-threatening infection. Any WBC below 3000 requires immediate discontinuation of clozapine and urgent medical intervention. This is the most critical and life-threatening finding.
Correct Answer Is:
B. WBC – 2500/mm³
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