A client with schizophrenia has had 2 hospitalizations within the past 9 months due to non-adherence to medications and their counseling plan. What measures should the nurse and the mental health treatment team recommend for tertiary prevention? (Select All That Apply)

Recommend the client distance themselves from people who knew them before their diagnosis.

Provide the client with a multi-step written plan to follow if auditory hallucinations occur.

Risperidone as a depot formulation every 2 weeks.

Increase white bread and bananas to help with anticholinergic symptoms.

Assist the client to enroll in a program of assertive community treatment.

Answer and Explanation

Correct Answer : B,C,E

Choice A Reason:

Recommending the client distance themselves from people who knew them before their diagnosis is not a suitable measure for tertiary prevention. Tertiary prevention aims to reduce the impact of an ongoing illness by helping patients manage long-term, complex health problems and injuries. It focuses on improving quality of life and reducing symptoms. Distancing from familiar people could lead to social isolation, which might worsen the client’s condition.

Choice B Reason:

Providing the client with a multi-step written plan to follow if auditory hallucinations occur is a practical measure for tertiary prevention. This plan can help the client manage symptoms effectively and reduce the likelihood of hospitalization. It empowers the client to take control of their symptoms and provides clear steps to follow during a crisis, which can be crucial for maintaining stability.

Choice C Reason:

Risperidone as a depot formulation every 2 weeks is an effective measure for ensuring medication adherence in clients with schizophrenia. Depot formulations are long-acting injections that help maintain consistent medication levels in the body, reducing the risk of relapse due to missed doses. This approach is particularly beneficial for clients who have difficulty adhering to daily oral medication regimens.

Choice D Reason:

Increasing white bread and bananas to help with anticholinergic symptoms is not a recommended measure for managing schizophrenia. While diet can play a role in overall health, there is no evidence to suggest that these specific foods help with anticholinergic symptoms. Anticholinergic symptoms are typically managed with medications and other medical interventions.

Choice E Reason:

Assisting the client to enroll in a program of assertive community treatment (ACT) is a highly effective measure for tertiary prevention. ACT provides comprehensive, community-based psychiatric treatment, rehabilitation, and support to individuals with serious and persistent mental illnesses. This approach helps clients manage their symptoms, adhere to treatment plans, and reduce the risk of hospitalization by providing continuous, personalized care.

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Free Nursing Study Resources

Correct Answer is ["B","D","E"]

Explanation

Choice A Reason:

The statement “They do not need to report the use of herbal therapies to the provider” is incorrect. It is crucial for clients to inform their healthcare providers about any herbal therapies they are using. This is because herbal therapies can interact with prescription medications, potentially causing adverse effects or reducing the efficacy of the medications. Healthcare providers need to be aware of all substances a patient is taking to provide safe and effective care.

Choice B Reason:

The statement “Herbal therapies also have side effects and may interact with other medications being taken” is correct. Herbal therapies, despite being natural, can have potent effects on the body and may cause side effects. Additionally, they can interact with other medications, leading to potentially harmful interactions. For example, St. John’s wort can interact with antidepressants, and ginkgo biloba can affect blood clotting. Therefore, it is essential to consider these interactions when using herbal therapies.

Choice C Reason:

The statement “They need to stay away from all herbal therapies” is incorrect. While it is important to be cautious, it is not necessary to avoid all herbal therapies. Many herbal therapies can be beneficial when used appropriately and under the guidance of a healthcare provider. The key is to ensure that the herbal products are safe, effective, and do not interact negatively with other medications the client may be taking.

Choice D Reason:

The statement “Herbal therapies should be purchased from reliable manufacturers with a history of quality control of their product” is correct. The quality of herbal products can vary significantly between manufacturers. Choosing products from reputable manufacturers ensures that the products have been tested for purity, potency, and safety. Reliable manufacturers follow good manufacturing practices and have stringent quality control measures in place, reducing the risk of contamination and ensuring the product’s efficacy.

Choice E Reason:

The statement “They should always inform healthcare providers of the use of herbs” is correct. It is essential for clients to inform their healthcare providers about any herbal therapies they are using. This information helps healthcare providers to monitor for potential interactions and side effects, adjust medication dosages if necessary, and provide comprehensive care. Open communication between clients and healthcare providers is crucial for ensuring safe and effective treatment plans.

Correct Answer is ["125"]

Explanation

To calculate the infusion rate in drops per minute:

Identify the total volume to be infused: 125 mL
Identify the total time for infusion: 1 hour (which is 60 minutes)
Identify the drop factor: 60 gtts/mL

Step 1: Calculate the infusion rate in mL per minute.

Volume (mL) ÷ Time (minutes)
125 mL ÷ 60 minutes = 2.0833 mL per minute

Step 2: Calculate the infusion rate in drops per minute.

Infusion rate (mL per minute) × Drop factor (gtts/mL)
2.0833 mL per minute × 60 gtts/mL = 125 gtts per minute

The drug will infuse at 125 drops per minute.

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A client with schizophrenia has had 2 hospitalizations within the past 9 months due to non-adherence to medications and their counseling plan. What measures should the nurse and the mental health treatment team recommend for tertiary prevention? (Select All That Apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a routine health examination, the client tells the nurse about using a variety of herbal therapies for health maintenance. When discussing the use of herbs, the nurse cautions the client that: (SELECT ALL THAT APPLY)

Correct Answer is ["B","D","E"]

Explanation

An IV infusion of 125 mL of a GI prokinetic agent is ordered to be given over 1 hour. The nurse will use a microdrip infusion set (60 gtts/mL). How many drops per minute will the drug infuse at the proper rate? Use a preceding zero if necessary. Do not use trailing zeros.

Correct Answer is ["125"]

Explanation

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Which of the following nursing strategies would be most appropriate when caring for an individual who is delusional?

A client diagnosed with Illness Anxiety Disorder is prescribed clonazepam for underlying anxiety. Of the following, which is of utmost importance when caring for this client?

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