A nurse in a mental health facility is reinforcing teaching with a client about panic attacks.Which of the following statements by the client indicates an understanding of the instructions?

"I will sit with others in the activity room until the panic attack subsides."

"I will use abdominal breathing at the first sign of a panic attack."

"I will reduce physical activity to help avoid panic attacks."

"I will expect each panic attack to last about 45 minutes."

Answer and Explanation

The Correct Answer is B

The correct answer is B.

"I will use abdominal breathing at the first sign of a panic attack." The rationale is that abdominal breathing helps calm the sympathetic nervous system, which is responsible for the fight-or-flight response that triggers panic attacks. Abdominal breathing also increases oxygen intake and reduces hyperventilation, which can worsen panic symptoms.

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Correct Answer is B

Explanation

The correct answer is B.

Stop the infusion. The nurse should stop the infusion immediately to prevent further fluid accumulation and tissue damage. This is a priority action accordingto the ABCDE principle, which guides nurses to prioritize airway, breathing, circulation, disability, and exposure issues. Infiltration is a complication of IV therapy that occurs when fluid leaks into the surrounding tissue due to dislodgment or puncture of the catheter. The signs and symptoms of infiltration include edema, coolness, pallor, pain, and decreased flow rate at the insertion site.

A. A nurse discovers that a client's family member has administered a PCA dose. B. A nurse discovers that an electronic IV pump delivered twice the prescribed amount of fluid to a client. C. A nurse observes another nurse remove wrist restraints one at a time from a client who is currently calm. D. A nurse observes a client vomiting after receiving an oral pain medication. E. None F. None

Correct Answer is B

Explanation

A.While it is concerning that a client's family member administered a patient-controlled analgesia (PCA) dose, it is more appropriate to address this situation through immediate intervention, education, and communication with the healthcare provider. An incident report may not be necessary unless there are further complications or system issues related to this incident.

B.An error in fluid administration by an IV pump, especially when it involves delivering twice the prescribed amount, is a medication error that could have serious consequences, such as fluid overload or electrolyte imbalances. An incident report must be filed to document the event and investigate what went wrong with the equipment.

C.Removing wrist restraints one at a time, particularly when the client is calm, follows safe practice to prevent injury. This situation does not represent an error, violation, or adverse event, and does not require an incident report. Restraints should always be removed cautiously and gradually to ensure client safety.

D.A client vomiting after receiving an oral pain medication could be an adverse drug reaction. While this is important to document in the patient’s medical record, it may not always require an incident report unless it leads to further complications or indicates a medication error.

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A nurse in a mental health facility is reinforcing teaching with a client about panic attacks.Which of the following statements by the client indicates an understanding of the instructions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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