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Questions 148

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Extract:


Question 1 of 5

A client is admitted to the chemical dependency unit for poly-drug abuse. The client states, 'I don't know why you are all so worried; I am in control. I don't have a problem.' Which defense mechanism is being utilized?

Correct Answer: D

Rationale: Denial is the defense mechanism where the client refuses to acknowledge the reality of their substance abuse problem, minimizing its severity.

Question 2 of 5

The nurse is caring for clients in outpatient surgery. The mother of a four-year-old asks the nurse how to prepare her daughter for eye surgery. Which of the following statements by the nurse is BEST?

Correct Answer: C

Rationale: use puppet or doll to show where procedure is performed; explain procedure in simple terms and what the child will see, hear, taste, smell, and feel

Question 3 of 5

A 14-year-old boy comes in for a yearly exam and confides in the nurse that he feels embarrassed he is shorter than most of the girls in his class. He asks if he will catch up in height. The best therapeutic response from the nurse is

Correct Answer: B

Rationale: This response validates the boy’s feelings, provides factual reassurance about growth during puberty, and is empathetic without dismissing his concerns.

Question 4 of 5

A 56-year-old male with a long history of alcohol abuse is brought to the detox center per terms of his probation. He had his last drink 6 hours ago and seems confused and agitated. The nurse expects the physician to order

Correct Answer: B

Rationale: Chlordiazepoxide (Librium), a benzodiazepine, is used to manage alcohol withdrawal symptoms like confusion and agitation, preventing seizures.

Question 5 of 5

A 15-year-old client took a full bottle of extra-strength acetaminophen in a suicide attempt 5 hours prior to admission to the emergency department for treatment, and the serum level of the drug is 180 mcg/mL. Which of the following interventions does the nurse anticipate? Select all that apply.

Correct Answer: A,B,C,D,E

Rationale: Acetaminophen overdose requires NAC (
A), supportive care (
B), charcoal if within 4-8 hours (
C), hepatic monitoring (
D), and psychiatric consultation (E) for suicide attempt.

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