A nurse receives report that a client has been pacing the hallway continuously for almost twenty-four hours and talking excessively.
Which action is the priority?
Maintain trust and avoid behaviors that may increase agitation.
Order the client to go to their room & alert security.
Tell the client to sit down or risk isolation and loss of privileges.
Sedate the client after collecting a lithium level.
The Correct Answer is A
Maintain trust and avoid behaviors that may increase agitation. This is because the client is likely experiencing a manic episode, which is characterized by increased activity, rapid speech, and decreased need for sleep. The nurse should use a calm and supportive approach, provide a safe and structured environment, and avoid confrontation or criticism.
Choice B is wrong because ordering the client to go to their room and alerting security would escalate the situation and violate the client’s rights.
Choice C is wrong because telling the client to sit down or risk isolation and loss of privileges would be threatening and punitive, which could increase the client’s agitation and anger.
Choice D is wrong because sedating the client after collecting a lithium level would be premature and inappropriate without a physician’s order and without assessing the client’s vital signs, mental status, and medication history. Lithium is a mood stabilizer that can cause toxicity if the level is too high.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A two-hour postprandial glucose test is done to check your blood sugar level two hours after you eat a meal.
This test helps to diagnose diabetes or monitor its treatment. A normal blood sugar level for this test is less than 140 mg/dL.
Choice A is wrong because fasting means not eating for at least eight hours before the test. This is done for a fasting blood glucose test, not a postprandial one.
Choice B is wrong because before breakfast means before you eat anything in the morning. This is also done for a fasting blood glucose test, not a postprandial one.
Choice D is wrong because before glucose is consumed means before you drink a sugary liquid for a glucose tolerance test. This test measures how your body handles glucose after drinking it, not after eating a meal.
Correct Answer is D
Explanation
The question asks how many milligrams of the medication will be in 1 mL of D5W. To find this, we need to know the concentration of the medication in the solution.
Concentration is the amount of medication per unit volume of solution. We can use this formula:
Concentration = Mass / Volume
We know that 250 mg of the medication is diluted in 500 mL of D5W. So we can plug these values into the formula:
Concentration = 250 mg / 500 mL Simplifying, we get:
Concentration = 0.5 mg / mL
This means that there are 0.5 mg of the medication in every 1 mL of D5W. So the answer is
- To check our answer, we can use another formula:
Mass = Concentration x Volume
If we want to find the mass of the medication in 1 mL of D5W, we can multiply the concentration by the volume:
Mass = 0.5 mg / mL x 1 mL Simplifying, we get:
Mass = 0.5 mg
This matches our answer.
The other choices are wrong because they do not use the correct formula or values. Here is why:
Choice A is wrong because it uses the inverse of the concentration (1 / 0.5) instead of the concentration (0.5).
Choice B is wrong because it uses the mass of the medication (250 mg) instead of the concentration (0.5 mg / mL).
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