A female client is brought to the emergency department after police officers found her disoriented, disorganized, and confused. The nurse also determine the client is homeless and is exhibiting suspiciousness. This client's plan of care should include what priority problem?

Ineffective community coping.

B Disturbed sensory perception.

Self-care deficit.

Acute confusion.

Answer and Explanation

The Correct Answer is D

A.   Ineffective community coping may be a concern for a homeless individual but is not the priority in this scenario where the client is disoriented and confused.
B.   Disturbed sensory perception typically involves alterations in visual, auditory, tactile, or olfactory senses, which may not be the primary issue in this case.
C.   While self-care deficit could be a concern for a homeless individual, it is not the priority when the client is disoriented, disorganized, and confused.
D.   Acute confusion is the priority problem because the client is disoriented, disorganized, and confused, indicating a cognitive impairment that needs immediate attention. E. There is no specific rationale provided for this option.

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Correct Answer is A

Explanation

A. Responding with illogical answers to questions is characteristic of schizophrenia, particularly during periods of psychosis when the client may experience disorganized thinking and impaired reality testing.
B. Admitting to frequently thinking about committing suicide is not specific to schizophrenia and may occur in various mental health conditions, such as depression or bipolar disorder.
C. Describing times of depression followed by feelings of euphoria suggests a mood disorder, such as bipolar disorder, rather than schizophrenia.
D. Exhibiting compulsive, ritualistic behaviors may be seen in obsessive-compulsive disorder (OCD) but is not typically characteristic of schizophrenia. Schizophrenia is primarily characterized by positive symptoms (such as hallucinations and delusions), negative symptoms (such as blunted affect and social withdrawal), and cognitive symptoms (such as disorganized thinking and impaired executive function).

A. Alcohol. B. Benzodiazepine. C. Methamphetamine. D. Marijuana.

Correct Answer is C

Explanation

A. While excessive alcohol consumption can contribute to cardiovascular issues, including heart attacks, methamphetamine abuse is associated with a higher risk of myocardial infarction due to its potent sympathomimetic effects on the cardiovascular system.
B. Benzodiazepines primarily affect the central nervous system and are not typically associated with an increased risk of myocardial infarction.
C. Methamphetamine use is known to cause significant cardiovascular effects, including increased heart rate, blood pressure, and vasoconstriction, which can lead to myocardial infarction.
D. While marijuana use can have cardiovascular effects, it is generally less potent in its cardiovascular effects compared to methamphetamine.

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A female client is brought to the emergency department after police officers found her disoriented, disorganized, and confused. The nurse also determine the client is homeless and is exhibiting suspiciousness. This client's plan of care should include what priority problem?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is performing the admission assessment for a client with schizophrenia in an acute care inpatient facility. The nurse should identify which observed behavior is characteristic of schizophrenia?

Correct Answer is A

Explanation

The nurse is performing intake interviews at a psychiatric clinic. A client with a known history of drug abuse reports having had a heart attack four years ago. Use of which substance places the client at highest risk for myocardial infarction?

Correct Answer is C

Explanation

The nurse observes a client with a history of psychosis repeatedly looking to the side and mumbling responses to no one present in that direction. Which comment is best for the nurse to make?

The nurse has received a new prescription for the client to begin taking sertraline. Prior to administering the initial dose of sertraline, it is most important for the nurse to obtain which information?

The nurse notes that a client with a history of self-mutilation has increased body tension and is pacing in the hallway. Which nursing intervention is most important at this time?

Which intervention(s) should the nurse include in the plan of care for an adolescent client who is depressed? Select all that apply.

The nurse documents that a client with schizophrenia is delusional. Which statement by the client confirms this assessment?

A client with a history of alcoholism is admitted for detoxification. Based on treatment protocol, the nurse gives the client a dose of lorazepam 6 mg. Which additional prescription should the nurse administer immediately?