A nurse is preparing to assess an older client who is new to a medical-surgical unit. Upon entry to the client’s room, the nurse observes that the client answers questions appropriately but falls back to sleep immediately after their responses. Which of the following best describes the client’s level of consciousness?

Obtunded

Stuporous

Lethargic

Alert

Answer and Explanation

The Correct Answer is C

Choice A Reason:

Obtunded describes a state where the patient has a decreased level of consciousness and is difficult to arouse. They may respond slowly and be somewhat confused. This level of consciousness is more severe than lethargy and typically requires more vigorous stimulation to elicit a response. The client’s ability to answer questions appropriately before falling back to sleep suggests a less severe impairment than obtundation.

Choice B Reason:

Stuporous refers to a condition where the patient is almost entirely unresponsive and can only be aroused by vigorous and repeated stimuli. This state is more severe than lethargy and obtundation. The client’s ability to respond appropriately to questions indicates a higher level of consciousness than stupor. Therefore, stuporous is not the correct description of the client’s condition.

Choice C Reason:

Lethargic describes a state where the patient is very drowsy but can be aroused to respond to questions and then falls back to sleep. This matches the client’s presentation as they are able to answer questions appropriately but fall asleep immediately afterward. Lethargy is a common level of altered consciousness in various medical conditions and is less severe than obtundation or stupor.

Choice D Reason:

Alert describes a state where the patient is fully awake, aware, and responsive to stimuli. The client’s tendency to fall back to sleep immediately after responding to questions indicates that they are not fully alert. Therefore, this term does not accurately describe the client’s level of consciousness.

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Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A Reason:

Labeling mild anxiety as pathologic and suggesting that it warrants postponing the test is not accurate. Mild anxiety is a normal response to stress and can actually be beneficial in certain situations. It helps to increase alertness and focus, which can improve performance on tasks such as taking a test. Pathologic anxiety, on the other hand, is excessive and persistent, interfering with daily functioning and requiring clinical intervention.

Choice B Reason:

The idea that mild anxiety may be transferred to classmates and result in generalized anxiety disorder is not supported by evidence. Anxiety is a personal experience and while it can be influenced by the environment, it is not something that can be directly transferred from one person to another. Generalized anxiety disorder is a chronic condition characterized by excessive worry about various aspects of life, and it develops due to a combination of genetic, environmental, and psychological factors.

Choice C Reason:

While severe anxiety can interfere with cognitive ability, mild anxiety typically does not. In fact, mild anxiety can enhance cognitive performance by increasing alertness and focus. It is only when anxiety becomes overwhelming that it starts to impair cognitive functions such as memory, attention, and problem-solving.

Choice D Reason:

Mild anxiety is conducive to concentration and problem-solving. This level of anxiety can act as a motivator, helping individuals to focus better and perform tasks more efficiently. The Yerkes-Dodson law suggests that there is an optimal level of arousal (including anxiety) that enhances performance. Too little arousal can lead to underperformance, while too much can cause performance to deteriorate.

A. Cognitive Behavioral Therapy B. Psychoanalytic therapy C. Electroconvulsive (ECT) therapy D. Family systems therapy

Correct Answer is A

Explanation

Choice A Reason:

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is the most effective non-pharmacological treatment for anxiety disorders. CBT focuses on identifying and challenging negative thought patterns and behaviors that contribute to anxiety. It teaches clients practical skills to manage their anxiety, such as relaxation techniques, exposure therapy, and cognitive restructuring. Research has consistently shown that CBT can significantly reduce anxiety symptoms and improve overall functioning.

Choice B Reason:

Psychoanalytic therapy

Psychoanalytic therapy, based on the theories of Freud, aims to uncover unconscious conflicts and past experiences that influence current behavior. While it can be beneficial for some individuals, it is generally not considered the first-line treatment for anxiety disorders. Psychoanalytic therapy tends to be long-term and may not provide the immediate relief that clients with severe anxiety need.

Choice C Reason:

Electroconvulsive (ECT) therapy

Electroconvulsive therapy (ECT) involves the use of electrical currents to induce seizures in the brain and is primarily used to treat severe depression and certain other mental health conditions. It is not typically used as a treatment for anxiety disorders. ECT is considered a last-resort treatment when other therapies have failed, and it is not suitable for managing anxiety symptoms in most cases.

Choice D Reason:

Family systems therapy

Family systems therapy focuses on improving communication and relationships within the family unit. While it can be helpful for addressing family dynamics and support, it is not specifically designed to treat anxiety disorders. Family therapy may be used as an adjunct to other treatments, but it is not the primary approach for managing anxiety symptoms.

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Naxlex Comprehensive Predictor Exams

A 23-year-old is about to take a math test. A nursing assessment reveals mild anxiety. The nurse explains that this level of anxiety:

Correct Answer is C

Explanation

A client diagnosed with an Anxiety Disorder tells a nurse that being in crowds creates thoughts of losing control and the need to suddenly leave. What should the nurse recommend as an effective, non-pharmacological therapy for managing the client’s symptoms of anxiety?

Correct Answer is A

Explanation

A nurse is caring for a client who has schizophrenia. The client is in the dayroom and shouting at other clients, stating, “Do not eat the food here. The staff is poisoning the food!” The nurse should document that the client is experiencing which type of delusion?

During a morning group meeting, a client raises concern that they cannot sleep at night due to the noises coming from the nurse’s station. The nurse in the meeting interrupts and states, “I’ll handle this matter. Let’s move on.” The nurse is demonstrating which type of leadership style?

The nurse is caring for a client with schizophrenia. Which of the following would be a priority nursing goal for this client’s care?

The nurse calculates that a patient must receive 1.3 mL of an anti-infective agent. The dose is ordered IM. Which of the following choices demonstrates safe, evidence-based practice?

An IV infusion of 125 mL of a GI prokinetic agent is ordered to be given over 1 hour. The nurse will use a microdrip infusion set (60 gtts/mL). How many drops per minute will the drug infuse at the proper rate? Use a preceding zero if necessary. Do not use trailing zeros.

A nurse is preparing a presentation at a community center about complementary and alternative therapies. Which of the following therapies should the nurse describe as the use of an electronic monitoring device to help clients learn to control physical responses to stress?

The nurse must prepare an oral contrast solution in 850 mL of apple juice. There are 6-ounce containers of apple juice in the pantry. What is the minimum number of containers of juice to make 850 mL? (Round the answer to the nearest whole container)