An older adult client is brought into the behavioral health outpatient clinic by a family member. The family member is concerned that the client is hoarding again. Which information obtained by the family member is of most concern to the nurse that correlates with the suspicion? (Select all that apply.)

A large number of cats living in the home.

When trying to remove items, the client becomes angry and upset.

Unable to enter into the rooms due to clutter piled up.

The client is obsessively cleaning the same areas repeatedly.

The client is throwing away items in the home that are deemed "unnecessary."

Answer and Explanation

Correct Answer : B,C

Choice A reason: While having a large number of pets can be a sign of hoarding, it is not necessarily a concern unless it negatively impacts the living conditions.

Choice B reason: Becoming angry and upset when attempting to remove items is a common reaction in individuals who hoard, indicating an emotional attachment to possessions.

Choice C reason: Inability to enter rooms due to clutter is a clear sign of hoarding, as it indicates that the accumulation of items has significantly interfered with the intended use of living spaces.

Choice D reason: Obsessive cleaning of the same areas may indicate a different issue, such as obsessive-compulsive disorder, rather than hoarding.

Choice E reason: Throwing away items deemed "unnecessary" is not typically associated with hoarding behavior, as hoarding involves difficulty parting with items.

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Correct Answer is ["A","C","D","E"]

Explanation

Choice A: The narcotic count is incorrect when the nurse ends the shift

An incorrect narcotic count at the end of a shift is a serious issue that could indicate potential drug diversion. It's crucial for nurses to accurately count and document narcotics to ensure patient safety and maintain legal and ethical standards. Therefore, this behavior should be reported to the nurse manager.

Choice B: The nurse has poor hygiene practices and has an offensive body odor

While poor hygiene and offensive body odor can be disruptive and unpleasant in a workplace setting, they are not direct indicators of substance use disorder. However, it's important to note that changes in personal hygiene can sometimes be a sign of other health or personal issues.

Choice C: The observing nurse finds oral narcotics blister packs torn in the back

Finding torn narcotics blister packs could indicate that a nurse is diverting drugs for personal use. This is a serious violation of nursing practice and should be reported immediately.

Choice D: The clients are reporting a lack of pain control when the nurse is working

If patients consistently report a lack of pain control when a specific nurse is working, it could suggest that the nurse is not administering the prescribed pain medications properly¹?¹?¹?¹?¹?. This could be due to a variety of reasons, including potential drug diversion, and should be reported.

Choice E: The nurse administers narcotics and then goes to use the bathroom

Frequent bathroom breaks immediately after administering narcotics could be a red flag for drug diversion. While there could be other explanations, this behavior in the context of the other signs could indicate a substance use disorder and should be reported.

A. Sleeping 12 hours or more each day. B. Constant need to talk about the event. C. Increasing sense of attachment to others. D. Increasing feelings of anger.

Correct Answer is D

Explanation

Choice A reason: Sleeping excessively can be a response to depression or trauma, but it is not a specific symptom of PTSD.

Choice B reason: A constant need to talk about the event is not typical for PTSD, as individuals with PTSD often avoid reminders of the trauma.

Choice C reason: An increasing sense of attachment to others is not commonly associated with PTSD, which often involves feelings of detachment.

Choice D reason: Increasing feelings of anger are common in PTSD as individuals may have difficulty managing their emotions related to the trauma.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse suspects another nurse of substance use disorder while working in the long-term care facility. Which behavior(s) will the observing nurse report to the nurse manager? Select all that apply.

Correct Answer is ["A","C","D","E"]

Explanation

A nurse is assessing a client who has posttraumatic stress disorder (PTSD) following a sexual assault. Which of the following is an expected finding?

Correct Answer is D

Explanation

The nurse is working to develop a therapeutic nurse-client relationship with a client diagnosed with paranoid personality disorder. Which techniques will the nurse use to foster trust? Select all that apply.

A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? Select all that apply.

The nurse is talking with a client who grew up in a home where both parents were alcoholics. Which behaviors does the nurse identify when assessing this client that correlate with this home life? Select all that apply.

The nurse is teaching a client with paranoid personality disorder to validate ideas with another person before taking action. Which statement made by the client indicates that the teaching is effective?

During an assessment of family dynamics for a client with an eating disorder, which observed issue could indicate a reason for the client's eating disorder?

Which statement(s) made by the spouse indicates that they are exhibiting enabling behaviors? Select all that apply.

The nurse is working with clients with personality disorders that are having problems with relationships and other parts of their life. Which barrier(s) is the nurse experiencing when working with this group of clients? Select all that apply.