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Questions 158

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Question 1 of 5

The nurse is caring for a client with a history of a seizure disorder who is receiving Valproic acid (Depakote). The nurse should monitor the client for:

Correct Answer: A

Rationale: Valproic acid can cause hepatotoxicity, requiring monitoring of liver enzymes. Hypotension, hyperglycemia, and weight loss are not primary side effects.

Question 2 of 5

The nurse is caring for a client with a history of ectopic pregnancy. Which risk factor is most likely to be present?

Correct Answer: A

Rationale: Pelvic inflammatory disease (PI
D) is a major risk factor for ectopic pregnancy as it can scar the fallopian tubes impairing embryo transport. Gestational diabetes hypertension and multiple gestations are not strongly associated.

Question 3 of 5

The physician has prescribed metoclopramide (Reglan). When assessing the client, the nurse would expect to find which of the following responses?

Correct Answer: B

Rationale: This response is expected with metoclopramide, in addition to increasing gastric emptying.

Question 4 of 5

A 23-year-old female client is brought to the emergency room by her roommate for repeatedly making superficial cuts on her wrists and experiencing wide mood swings. She is very angry and hostile. Her medical diagnosis is adjustment disorder versus borderline personality disorder. The client comments to the nurse, 'Nobody in here seems to really care about the clients. I thought nurses cared about people!' The client is exhibiting the ego defense mechanism:

Correct Answer: C

Rationale: Reaction formation is the development and demonstration of attitudes and/or behaviors opposite to what an individual actually feels. The client's comment does reveal her anger and hostility. Rationalization, another ego defense mechanism, is offering a socially acceptable or seemingly logical explanation to justify one's feelings, behaviors, or motives. The client's comment does not reflect rationalization. Splitting, the viewing of people or situations as either all good or all bad, is frequently used by persons experiencing a disruption in self-concept. This ego defense mechanism is reflective of the individual's inability to integrate the positive and negative aspects of self. Sublimation, the channeling of socially unacceptable impulses and behaviors into more acceptable patterns of behavior, is another ego defense mechanism. The client's comment reveals that she is not engaging in sublimation.

Question 5 of 5

A client with nontropical sprue has an exacerbation of symptoms. Which meal selection is responsible for the recurrence of the client's symptoms?

Correct Answer: C

Rationale: Nontropical sprue (celiac disease) involves gluten intolerance. Crackers in the soup likely contain gluten, triggering symptoms. The other options are gluten-free.

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