ATI RN
Client Safety Alternatives to Restraints Quizlet Questions
Question 1 of 5
A client is diagnosed with schizophrenia. A physician orders haloperidol (Haldol) 50 mg bid, benztropine (Cogentin) 1 mg prn, and zolpidem (Ambien) 10 mg HS. Which client behavior would warrant the nurse to administer benztropine?
Correct Answer: C
Rationale: The correct answer is C: Restlessness and muscle rigidity. Benztropine is an anticholinergic medication commonly used to treat extrapyramidal symptoms such as restlessness and muscle rigidity, which can occur as side effects of antipsychotic medications like haloperidol. Tactile hallucinations (choice A) would not be a direct indication for benztropine. Tardive dyskinesia (choice B) is a late side effect of antipsychotic medications and is not an acute symptom requiring benztropine. Reports of hearing disturbing voices (choice D) are indicative of auditory hallucinations, which would not be treated with benztropine.
Question 2 of 5
The nurse cares for a client who just had a massive myocardial infarction (MI). Which of the following stress reduction techniques would be applicable to this client? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A: Promote a heart healthy diet. Following a heart-healthy diet can help manage risk factors for further cardiac events. A diet high in fruits, vegetables, whole grains, lean proteins, and low in saturated fats can help reduce cholesterol levels and blood pressure. Choices B, C, and D are incorrect. B: Encouraging cigarette cessation is crucial as smoking increases the risk of further cardiovascular issues. C: While sleep is important, the immediate focus should be on heart health interventions. D: After a massive MI, low-intensity exercise may not be safe until the client's condition stabilizes.
Question 3 of 5
The nurse cares for a patient, who has been taking ibuprofen for back pain x 3 weeks, was admitted to the hospital for abdominal pain. Which assessment data takes priority?
Correct Answer: C
Rationale: Rationale: 1. Occult blood in stool can indicate gastrointestinal bleeding, a serious complication of prolonged ibuprofen use. 2. Gastrointestinal bleeding can lead to anemia, hypovolemia, and shock. 3. Promptly addressing bleeding is crucial to prevent further complications. 4. Diarrhea, Hematuria, and Ova & Parasites are less likely related to ibuprofen use for back pain and are not immediate priorities.
Question 4 of 5
The nurse is developing a plan of care for a client with disturbed body image. Which interventions would the nurse most likely include in the plan? Select all that apply.
Correct Answer: A
Rationale: The correct answer is A (Establish rapport with the client) because building a trusting relationship is essential in addressing disturbed body image. By establishing rapport, the nurse can create a safe environment for the client to express their feelings and concerns. Choice B (Role model appropriate behavior) may not directly address the client's distorted body image issues and might not be as effective as building rapport. Choice C (Encourage client to make positive self-statements) may be helpful in boosting self-esteem, but it may not address the underlying causes of the disturbed body image. Choice D (Assist the client in accepting responsibility for own actions) is not directly related to addressing disturbed body image and may not be as effective as building rapport in this context.
Question 5 of 5
In relationship to the nurse's ability to communicate with a client, which type of communication most effectively demonstrates professional competence?
Correct Answer: C
Rationale: The correct answer is C: Interpersonal. Interpersonal communication involves direct interaction between the nurse and client, showcasing active listening, empathy, and respect. This type of communication fosters trust, understanding, and therapeutic relationships, reflecting professional competence. Public communication (A) involves addressing large audiences and may lack the personal connection needed in client interactions. Small group communication (B) involves communication within a limited group and may not be as focused on individual client needs. Intrapersonal communication (D) refers to self-talk and reflection, which is important but not directly related to communicating with clients.