A nurse is caring for a client who ingested a selective serotonin reuptake inhibitor and St. John's Wort. Which of the following findings should the nurse identify as being consistent with serotonin syndrome?

Tinnitus and jerking movements

Pill rolling movements and drooling

Suicidal ideations

Dilated pupils and loss of muscle coordination

Answer and Explanation

The Correct Answer is D

A. Tinnitus and jerking movements are not typical signs of serotonin syndrome.
B. Pill rolling movements and drooling are more characteristic of Parkinsonian symptoms, not serotonin syndrome.
C. Suicidal ideations, while a serious mental health concern, are not specific to serotonin syndrome.
D. Dilated pupils and loss of muscle coordination are consistent with serotonin syndrome, which is a potentially life-threatening condition caused by excessive serotonin activity in the central nervous system. Other symptoms may include agitation, confusion, rapid heart rate, high blood pressure, dilated pupils, and muscle rigidity.

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Correct Answer is A

Explanation

A. This response validates the client's feelings and opens up a dialogue for the client to express their thoughts and concerns about group therapy, which is a key aspect of therapeutic communication.

B. This response may come across as dismissive of the client's feelings and does not encourage open communication.

C. While this response acknowledges the client's feelings, it does not encourage the client to share more about their concerns.

D. This response makes assumptions about the client's feelings and does not invite them to express their thoughts.

A. "Nursing interventions for this diagnosis are very limited, regardless of age." B. "Usually, older clients have better treatment outcomes." C. "Assessing for thoughts of self-harm is important, regardless of age.” D. "Usually, only adults are on psychiatric medication for this disorder.”

Correct Answer is C

Explanation

A. Nursing interventions are crucial for both children and adults with dissociative identity disorder, and they involve tailored approaches depending on developmental needs.

B. Treatment outcomes can vary widely and are not necessarily better for older clients. Treatment success depends on various factors including individual circumstances and the presence of supportive therapies.

C. Assessing for thoughts of self-harm is critical in both children and adults with dissociative identity disorder, as self-harm is a potential risk in this population.

D. Both children and adults with dissociative identity disorder may be prescribed psychiatric medications, depending on their symptoms and treatment needs.

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A nurse is caring for a client who ingested a selective serotonin reuptake inhibitor and St. John's Wort. Which of the following findings should the nurse identify as being consistent with serotonin syndrome?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is refusing to attend group therapy. The client states, "I don't know why you think I need therapy. I am fine without it."" Which of the following responses by the nurse indicates a therapeutic response?

Correct Answer is A

Explanation

A nurse is discussing treatment options with the guardian of a child who has been diagnosed with dissociative identity disorder. The guardian asks, "How is nursing care different for children diagnosed with dissociative identity disorder compared to adults?" How should the nurse best respond?

Correct Answer is C

Explanation

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