A male client with a long history of alcohol dependency arrives in the Emergency Department describing the feeling of bugs crawling on his body. His blood pressure is 170/102 mm Hg, pulse rate is 110 beats/minute, and blood alcohol level (BAL) is 0 mg/dL. Which prescription should the nurse administer?

Haloperidol.

Lorazepam.

Diphenyhydramine.

Thiamine.

Answer and Explanation

The Correct Answer is B

A) Haloperidol is an antipsychotic that may be used for agitation or hallucinations, but it is not the first-line treatment for alcohol withdrawal symptoms. Administering haloperidol without addressing withdrawal may not be effective and could lead to further complications.

B) Lorazepam is a benzodiazepine and is the preferred medication for managing alcohol withdrawal symptoms, including agitation, anxiety, and hallucinations. It helps reduce the risk of severe withdrawal symptoms and seizures while providing sedative effects. Given the client’s symptoms of feeling bugs crawling on his body, which may indicate tactile hallucinations due to withdrawal, lorazepam would be the most appropriate choice.

C) Diphenhydramine is an antihistamine that can be used for allergic reactions or as a sedative, but it is not effective for managing alcohol withdrawal symptoms.

D) Thiamine is important to prevent Wernicke's encephalopathy in clients with a history of alcohol dependency, especially if there are signs of confusion or neurological deficits. However, it does not address the immediate symptoms of withdrawal the client is experiencing.

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Correct Answer is D

Explanation

A) Asking the client why she is so anxious might seem like a valid approach to understand her feelings; however, at this moment, she may not be able to articulate her anxiety effectively. Instead of exploring the reasons for her anxiety right away, it's more important to provide immediate support.

B) Administering a PRN sedative can provide temporary relief for severe anxiety, but it should not be the first line of intervention during the admission process. Pharmacological intervention is important, but establishing a therapeutic relationship and using non-pharmacological approaches can be equally or more effective in the long term.

C) Assisting the client in developing alternative coping skills is a valuable intervention, but it may not be appropriate to initiate this process immediately during the admission phase when the client is experiencing acute anxiety. The client needs first to feel safe and stabilized.

D) Remaining calm and using a matter-of-fact approach is the most important intervention during the admission process. This approach helps create a safe environment and reassures the client. By modeling calmness, the nurse can help reduce the client’s anxiety levels and foster a sense of security, allowing for better engagement and assessment.

A. Explains answers to open-ended questions. B. Reports enjoyment from assigned activities. C. Shares a personal story with peers. D. Performs activities of daily living.

Correct Answer is D

Explanation

(A) Explains answers to open-ended questions:While explaining answers to open-ended questions indicates cognitive engagement, it does not directly address avolition, which is characterized by a lack of motivation to perform purposeful activities.

(B) Reports enjoyment from assigned activities:Reporting enjoyment from activities is a positive sign, but it does not necessarily indicate an improvement in the motivation to initiate and complete tasks independently.

(C) Shares a personal story with peers:Sharing personal stories can demonstrate social engagement, but it does not directly reflect an improvement in avolition, which involves the motivation to perform daily tasks.

(D) Performs activities of daily living:Performing activities of daily living (ADLs) demonstrates an improvement in avolition, as it shows the client is motivated to take care of themselves and engage in necessary daily tasks. This behavior directly aligns with the goal of improving avolition.

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Naxlex Comprehensive Predictor Exams

During admission to the psychiatric unit, a female client is extremely anxious and expresses that she is worried about the sun coming up the next day. Which intervention is most important for the nurse to implement during the admission process?

Correct Answer is D

Explanation

The mental health team working with a homeless client with chronic schizophrenia establishes the treatment goal of, "Improvement in avolition prior to discharge." Which behavior demonstrates achievement of this goal to the nurse?

Correct Answer is D

Explanation

The nurse is leading a group on the inpatient psychiatric unit. Which approach should the nurse use during the working phase of group development?

A young adult client is admitted to a psychiatric facility with a diagnosis of bulimia nervosa. Which nursing intervention has the highest priority?

The mental health nurse observes that a female client with delusional disorder carries some of her belongings with her because she believes that others are trying to steal them. Which nursing action will promote trust?

The healthcare provider prescribes lithium carbonate for a client diagnosed with bipolar, manic depression. It is most important for the nurse to review which laboratory finding prior to beginning the drug therapy?

The nurse is caring for client who is experiencing extreme sadness after the passing of a companion of 30 years. The client describes not being able to think of other things and finds it difficult to control emotions. Which action should the nurse take first?