Extract:

Question 1 of 5

A client was discharged from an alcohol rehabilitation program on clonazepam (Klonopin) 0.5 mg TID. Several months later he reports having insomnia, shakiness, sweating and one seizure. The nurse should first ask the client if he:

Correct Answer: C

Rationale: Asking if the client stopped taking Klonopin suddenly is first, as abrupt cessation can cause withdrawal symptoms like insomnia, shakiness, sweating, and seizures, matching the client's presentation.

Question 2 of 5

A client is brought to the hospital by police and admitted involuntarily. She is diagnosed as having bipolar disorder, manic phase. The physician orders lithium carbonate. The client refuses her morning dose of lithium. The nurse should next:

A. Force the client to take the lithium because of the client's involuntarily admission status. B. Contact the physician to change the lithium order to be given intramuscularly. C. Inform the client that she retains the right to refuse medication despite her involuntary admission. D. Tell the client that certain privileges will be revoked if she does not take the medication.

Correct Answer: C

Rationale: Clients retain the right to refuse medication unless deemed incompetent or an immediate danger, requiring legal processes.

Question 3 of 5

A nurse is assessing a client experiencing hypomania who wants to stop her mood stabilizing medication because she is 'feeling good,' has a high energy level and thinks she is productive at work. Which response by the nurse is most appropriate?

A. Maybe you really don't need your medication anymore.' B. If you stop your medication, your behavior will quickly spiral out of control.' C. I believe you were hospitalized the last time you stopped your medication.' D. Why don't you cut your medication dosage in half for a while and see how you respond?'

Correct Answer: C

Rationale: Reminding the client of past consequences reinforces the importance of medication adherence.

Question 4 of 5

A 17-year-old is admitted to a psychiatric day treatment program due to severe lower back pain since her mother's death 3 years ago. Medical examinations, the nurse's health care for her pain. She cares for her four younger siblings after school and on weekends because of her father's long work hours. Which pre-discharge statement indicates that treatment for her condition has been successful?

A. I understand now why my father spends so much time away from home.' B. My back pain is worse on weekends with more chores and homework.' C. I don't want to talk about my family. It's my back that is hurting.' D. I just need more time and relaxation and then my back will feel fine.'

Correct Answer: D

Rationale: This statement indicates the client recognizes the link between stress and her pain, suggesting treatment success.

Question 5 of 5

When developing the plan of care for a client who is staying in his room because he perceives that staff want to harm him, which of the following outcomes of care planning is most realistic?

A. Within 2 days the client will complete his activities of daily living. B. Within 3 days the client will participate in recreation with other clients. C. Within 4 days the client will demonstrate an absence of verbal aggression. D. Within 5 days the client will seek out staff to talk about feelings.

Correct Answer: D

Rationale: Given the client's paranoid perceptions, seeking out staff to discuss feelings within 5 days is a realistic initial step toward building trust, compared to more complex or socially demanding outcomes.