A male client with bipolar disorder reports to the practical nurse (PN) that he has not taken his prescribed medication, divalproex sodium, for the last 6 months. Assessment of which parameter is most important for the PN to obtain?

Frame of mind.

Speech pattern.

Hyperactivity.

Headache pain.

Answer and Explanation

The Correct Answer is A

A. Frame of mind: Assessing the client’s current mental and emotional state is the top priority because discontinuation of divalproex sodium can lead to recurrence of manic or depressive episodes. Evaluating mood stability, presence of suicidal or manic thoughts, and overall mental status helps determine immediate safety needs and guides further intervention.

B. Speech pattern: While pressured or rapid speech may indicate mania, it is a secondary observation that supports mood assessment rather than the initial focus. The PN must first establish the client’s overall psychological state before analyzing communication details.

C. Hyperactivity: Increased activity and restlessness can occur in mania, but this symptom should be assessed in the broader context of the client’s mood and thought processes, making it less urgent than assessing overall frame of mind.

D. Headache pain: Headache is not typically associated with medication discontinuation in bipolar disorder. Although physical discomfort should be noted, it does not provide critical information about the client’s psychiatric stability or immediate risk level.

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Free Nursing Study Resources

Correct Answer is B,C,A,D,E

Explanation

A. Release air from the cuff slowly: Air is released gradually (2–3 mmHg per second) to allow accurate identification of Korotkoff sounds while preventing false readings.

B. Position the blood pressure cuff: The PN first places the cuff snugly around the upper arm, ensuring it is at heart level and the artery marker aligns with the brachial artery for accurate measurement.

C. Pump the cuff while palpating the pulse: The PN inflates the cuff until the radial pulse disappears to estimate systolic pressure, helping determine how high to inflate when taking the actual reading.

D. Listen for the systolic pressure reading: The first clear tapping sound heard through the stethoscope indicates the systolic blood pressure — the pressure during ventricular contraction.

E. Listen for the diastolic pressure reading: The disappearance of the sounds marks the diastolic pressure, representing the pressure during ventricular relaxation, which is recorded as the lower number in the BP reading.

A. Checks the medical record for the correct signed consent form prior to the examination. B. Asks if the client understands the exam and why the consent form must be signed. C. Explains the examination and ask the client to sign the consent form. D. Explains to a family member and obtain their signature on the consent form.

Correct Answer is A

Explanation

A. Checks the medical record for the correct signed consent form prior to the examination: The PN’s role is to verify that a valid, signed consent form is on file before the procedure. This ensures legal and ethical compliance while confirming that the client has been properly informed by the provider.

B. Asks if the client understands the exam and why the consent form must be signed: Assessing client understanding is the responsibility of the provider who explains the procedure. The PN can reinforce understanding but cannot obtain informed consent independently.

C. Explains the examination and asks the client to sign the consent form: Explaining the procedure and obtaining signatures is the provider’s responsibility. The PN can clarify information and answer questions, but cannot replace the provider in securing consent.

D. Explains to a family member and obtain their signature on the consent form: Consent must come from the client unless they are legally unable to provide it. Involving a family member without proper authorization could violate the client’s rights and legal requirements.

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A male client with bipolar disorder reports to the practical nurse (PN) that he has not taken his prescribed medication, divalproex sodium, for the last 6 months. Assessment of which parameter is most important for the PN to obtain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is assessing a client's blood pressure using a manual sphygmomanometer on the left arm. In which sequence should the PN implement these actions? (Arrange from first action on top to last on the bottom.)

Correct Answer is B,C,A,D,E

Explanation

Prior to an invasive examination of a hospitalized client, a consent form should be obtained. Which action best describes the responsibility of the practical nurse (PN)?

Correct Answer is A

Explanation

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